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  • Neutropenic after 2nd Bleo

    Hey everyone so yesterday I was looking forward to my second shot of bleo since I've had a pretty bad time with week 1 nausea and thought the bleo would be easier on my body. Boy was I wrong! I ended up in the ER with 102.8 fever and antibiotics. My WBC was 1.7.

    Needless to say I'm not looking forward to my last bleo shot on Tuesday. Has anyone had experience with this and did it happen every time you got bleo? This didn't happen after my first dose.
    26 Cleveland, OH
    3/01/17 - Found lump on right testicle
    4/21/17 - Went to ER. 4x3.7x2.5 cm tumor in right testicle
    4/22/17- Pre/op LDH 194, AFP 41, HCG 46, CT scan clear, X-ray clear
    4/27/17 - Right I/O. Non-seminoma with LVI. 70% EC, 20% Yolk Sac, 10% Teratoma
    5/16/17 - Markers normalize, CT clear. Stage 1B
    5/22/17 - Start 1xBEP

  • #2
    My WBC was low after the first week of cycle 3. In turn, chemo was pushed back a week to let my body build up. After 2 1/3 cycles, our immune system takes a beating. I'm sorry to hear that you got a fever, I hope you're bouncing back from it okay.

    Comment


    • #3
      ZICARIAS~ Ugh! Sorry about the fevers. Most patients will be Neutropenic during 3xBEP, not everyone will get a fever though. Everyone is different though in terms of hitting lowest WBC, my son's WBC & Neut count was lowest during 3rd cycle. My son's Pedi Oncologist really drove home staying away from most crowds, etc. while my son was not admitted to the hospital. I really think it helped. Hang in there!!!
      Son Grant
      dx 12/21/16 at age 17

      BEP x3
      Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
      2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
      Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

      Comment


      • #4
        Thanks for the advice, my oncologist reassured me that it's fairly common with BEP. Unfortunately I have to stay a second night in the hospital but better safe than sorry. Hope to be out tomorrow
        26 Cleveland, OH
        3/01/17 - Found lump on right testicle
        4/21/17 - Went to ER. 4x3.7x2.5 cm tumor in right testicle
        4/22/17- Pre/op LDH 194, AFP 41, HCG 46, CT scan clear, X-ray clear
        4/27/17 - Right I/O. Non-seminoma with LVI. 70% EC, 20% Yolk Sac, 10% Teratoma
        5/16/17 - Markers normalize, CT clear. Stage 1B
        5/22/17 - Start 1xBEP

        Comment


        • #5
          For me, taking steroids during bleo took away almost all side effects!! Are you getting those as an infusion?
          July 2016 - Left I/O
          December 2016 - BEPx3
          All clear for 1 year!

          My Testicular Cancer Support Kit
          First Oncologist Visit Checklist
          3 Things I Wish I Knew Before I Started Chemo
          3 Reasons Why People Disappear From Your Life During Cancer
          Simplify Cancer Podcast

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          • #6
            I think I wasn't only given steroids on day 1 and 3. I don't think I got anything around day 9 which was the bleo, other than Tylenol and Benadryl. I'm going to consult my oncologist before my next dose
            26 Cleveland, OH
            3/01/17 - Found lump on right testicle
            4/21/17 - Went to ER. 4x3.7x2.5 cm tumor in right testicle
            4/22/17- Pre/op LDH 194, AFP 41, HCG 46, CT scan clear, X-ray clear
            4/27/17 - Right I/O. Non-seminoma with LVI. 70% EC, 20% Yolk Sac, 10% Teratoma
            5/16/17 - Markers normalize, CT clear. Stage 1B
            5/22/17 - Start 1xBEP

            Comment


            • #7
              You probably had a reaction to the Bleomycin. Less likely an infection. But to be prudent, you need the antibiotics.

              Neutropenia with BEP is very common. It's to be expected.
              Diagnosed at age 31. Treated in NYC. Now living in Ottawa, ON, Canada.

              7/1/2015: felt tiny lump on side of R testicle
              7/30/2015: Ultrasound shows 2 intra-testicular masses.
              7/31/2015: tumor markers normal, CXR clear
              8/5/2015: R orchiectomy
              8/11/2015: Pathology: 1.2 x 1.0 x 1.0 cm, embryonal 80%, seminoma 20%, with LVI and rete testis invasion
              8/14/2015: CT abdomen/pelvis clear, Stage 1b
              8/24/2015: started 1 x BEP

              Comment


              • #8
                Yep, they're confident it's not an infection but my WBC and ANC continues to drop. They discharged me tonight and reinforced the important of returning if I develop another fever. He wants to avoid neulasta since I'm only doing 1 round of BEP and it can have some potential side effects/interactions with the bleo. My levels are expected to start rising towards the end of week 3 so for now I play it safe and try not to get sick.
                26 Cleveland, OH
                3/01/17 - Found lump on right testicle
                4/21/17 - Went to ER. 4x3.7x2.5 cm tumor in right testicle
                4/22/17- Pre/op LDH 194, AFP 41, HCG 46, CT scan clear, X-ray clear
                4/27/17 - Right I/O. Non-seminoma with LVI. 70% EC, 20% Yolk Sac, 10% Teratoma
                5/16/17 - Markers normalize, CT clear. Stage 1B
                5/22/17 - Start 1xBEP

                Comment


                • #9
                  Yes, there have been some studies showing Bleomycin induced pneumonitis increases with Neulasta use in Hodgkin's patients. I personally avoided the Neulasta as well. I was neutropenic for 2 weeks. If you get an infection, it will most likely come from your gut flora, not a sick person nearby. However, stay away from crowds as well.
                  Diagnosed at age 31. Treated in NYC. Now living in Ottawa, ON, Canada.

                  7/1/2015: felt tiny lump on side of R testicle
                  7/30/2015: Ultrasound shows 2 intra-testicular masses.
                  7/31/2015: tumor markers normal, CXR clear
                  8/5/2015: R orchiectomy
                  8/11/2015: Pathology: 1.2 x 1.0 x 1.0 cm, embryonal 80%, seminoma 20%, with LVI and rete testis invasion
                  8/14/2015: CT abdomen/pelvis clear, Stage 1b
                  8/24/2015: started 1 x BEP

                  Comment


                  • #10
                    ZICARIAS~ Yes, some Oncologists avoid the shots for Neutropenia. Dr. Einhorn did NOT recommend a shot for my son via email, and his Pedi Oncologist also had no plans for it either. Usually by first week of new cycle counts start going back up. The fever though demands immediate attention if it recurs. The Pedi Oncologist does have my teen on antibotics on the weekends only since January thru end of June.
                    Son Grant
                    dx 12/21/16 at age 17

                    BEP x3
                    Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                    2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                    Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                    Comment


                    • #11
                      Did you also get the shakes along with the fever? The so called "shake & bake" reaction to bleo is pretty common & has nothing to do with white counts or infection. I had it with my second bleo infusion, & they gave me tylenol pre-emptively before each ongoing bleo I never got it again.

                      If I recall correctly, bleo does not reduce white counts.
                      Dave
                      Jan, 1975: Right I/O, followed by RPLND
                      Dec, 2009: Left I/O, followed by 3xBEP

                      Comment


                      • #12
                        I'm about to start cycle 2 or 3, and so far bleo has had very little to no affect on me, however my wbc was .90, normal is 3.7-11.0. Getting injections to help with wbc currently, and can't work the rest of the week.

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