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Treating neutropenia with neopogen, leukine, or…?
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Treating neutropenia with neopogen, leukine, or…?

› Forums › Cutaneous Melanoma Community › Treating neutropenia with neopogen, leukine, or…?

  • Post
    • March 12, 2013 at 12:21 am
    swissfarm7
    Participant

      Hi, all!  Hans is 4+  months through his year-long interferon treatment.   This comes after his Stage 3B diagnosis last July and subsequent lymph node dissection.   Compared to many people, his side effects have been manageable.  He's lost 25 pounds (and was trim & fit to begin with, so he didn't have weight to lose) and is generally more fatigued, but he's continued working on our farm and takes on occasional ski day. 

      Hi, all!  Hans is 4+  months through his year-long interferon treatment.   This comes after his Stage 3B diagnosis last July and subsequent lymph node dissection.   Compared to many people, his side effects have been manageable.  He's lost 25 pounds (and was trim & fit to begin with, so he didn't have weight to lose) and is generally more fatigued, but he's continued working on our farm and takes on occasional ski day. 

      His white blood cell and neutrophil counts have been critically low for quite some time, so his dosage was halved.  The counts have continued sinking, though, and he now needs to consider stopping the treatment temporarily (or permanently) or taking another drug to treat the neutropenia.  His local oncologist recommended neupogen twice weekly.  I've heard of people with other forms of cancer receiving chemo and taking neopogen.  I read that leukine might be more appropriate for melanoma patients. 

      Anyone have experience with this and care to share your thoughts?  As in the past, I'm not asking for opinions on interferon treatment, though I have no doubt someone will feel the need to comment to that end. 😉  I'm specifically looking for info on neutropenia and the drugs mentioned above.  Thank you!

      Best,

      Colleen

    Viewing 8 reply threads
    • Replies
        • March 12, 2013 at 2:29 am
        Janner
        Participant

          I copied the stuff below from a Non-Hodgkin's Lymphoma page about the three drugs.  It may not directly translate to melanoma.  While Leukine is certainly used as an adjuvant treatment for melanoma (mixed results but it didn't seem to past muster as a melanoma therapy by itself), that may not make it the best choice for fixing neutropenia.  The other drugs might work better.  I think I'd probably go with whatever drug  my doctor recommended as they might be better at adjusting dosages and such for a drug they use all the time.  I have certainly seen others on this site post about taking Neupogen.  

           

           

          Neupogen (Filgrastim)

          Neupogen – Granulocyte Colony Stimulating Factor (or G-CSF) helps stimulate the production of Neutrophils. Neutrophils are the infection fighting white blood cells, so  Neupogen can help prevent chemotherapy induced neutropenia, and opportunistic infections. Its use during regular chemotherapy is not required, but often used anyway, especially for patients who already have compromised white cell counts.  During stem cell/bone marrow transplants it is almost 100% certain the patient will be given Neupogen injections. Injections are given daily, usually at the 5mcg per kilogram of body weight dose, for one week or longer. To read more about Neupogen click the link below.

          http://www.neupogen.com/pi.html

           

          Neulasta (Peg-Filgrastim)

          Neulasta is the once per chemotherapy cycle version of Neupogen. Instead of daily injections just one injection is required for each cycle of chemotherapy. For more information about Neulasta click the link below:

          http://www.neulasta.com/patient/index.jsp

           

          Leukine (Sargramostim)

          Similar to Neupogen, Leukine also stimulates the production of Neutrophils, but it goes one step further and also promotes the macrophages. Therefore it is called GM-CSF (Granuloctye Macrophage-Colony Stimulating Factor)  Recent studies have shown that for the purposes collecting enough CD34+ Stem Cells for transplant, Neupogen is more effective than Leukine, and Neupogen plus Leukine offers no additional benefit, but the cost is significantly higher. For more information about Leukine click the link below:

          http://www.leukine.com

          • March 12, 2013 at 2:29 am
          Janner
          Participant

            I copied the stuff below from a Non-Hodgkin's Lymphoma page about the three drugs.  It may not directly translate to melanoma.  While Leukine is certainly used as an adjuvant treatment for melanoma (mixed results but it didn't seem to past muster as a melanoma therapy by itself), that may not make it the best choice for fixing neutropenia.  The other drugs might work better.  I think I'd probably go with whatever drug  my doctor recommended as they might be better at adjusting dosages and such for a drug they use all the time.  I have certainly seen others on this site post about taking Neupogen.  

             

             

            Neupogen (Filgrastim)

            Neupogen – Granulocyte Colony Stimulating Factor (or G-CSF) helps stimulate the production of Neutrophils. Neutrophils are the infection fighting white blood cells, so  Neupogen can help prevent chemotherapy induced neutropenia, and opportunistic infections. Its use during regular chemotherapy is not required, but often used anyway, especially for patients who already have compromised white cell counts.  During stem cell/bone marrow transplants it is almost 100% certain the patient will be given Neupogen injections. Injections are given daily, usually at the 5mcg per kilogram of body weight dose, for one week or longer. To read more about Neupogen click the link below.

            http://www.neupogen.com/pi.html

             

            Neulasta (Peg-Filgrastim)

            Neulasta is the once per chemotherapy cycle version of Neupogen. Instead of daily injections just one injection is required for each cycle of chemotherapy. For more information about Neulasta click the link below:

            http://www.neulasta.com/patient/index.jsp

             

            Leukine (Sargramostim)

            Similar to Neupogen, Leukine also stimulates the production of Neutrophils, but it goes one step further and also promotes the macrophages. Therefore it is called GM-CSF (Granuloctye Macrophage-Colony Stimulating Factor)  Recent studies have shown that for the purposes collecting enough CD34+ Stem Cells for transplant, Neupogen is more effective than Leukine, and Neupogen plus Leukine offers no additional benefit, but the cost is significantly higher. For more information about Leukine click the link below:

            http://www.leukine.com

              • March 12, 2013 at 4:03 pm
              swissfarm7
              Participant

                Thank you for this, Janner.  Hans's local oncologist has limited experience with melanoma so I'm wondering what others in this position have heard from their docs.  I think Hans may contact the medical oncologist at Seattle Cancer Care Alliance who specializes in melanoma and with whom he consulted originally.  I feel so much better about the people at SCCA than I do this local guy.  Unfortunately, our health insurance carrier doesn't agree.

                Best,

                Colleen

                • March 12, 2013 at 4:03 pm
                swissfarm7
                Participant

                  Thank you for this, Janner.  Hans's local oncologist has limited experience with melanoma so I'm wondering what others in this position have heard from their docs.  I think Hans may contact the medical oncologist at Seattle Cancer Care Alliance who specializes in melanoma and with whom he consulted originally.  I feel so much better about the people at SCCA than I do this local guy.  Unfortunately, our health insurance carrier doesn't agree.

                  Best,

                  Colleen

                  • March 12, 2013 at 4:03 pm
                  swissfarm7
                  Participant

                    Thank you for this, Janner.  Hans's local oncologist has limited experience with melanoma so I'm wondering what others in this position have heard from their docs.  I think Hans may contact the medical oncologist at Seattle Cancer Care Alliance who specializes in melanoma and with whom he consulted originally.  I feel so much better about the people at SCCA than I do this local guy.  Unfortunately, our health insurance carrier doesn't agree.

                    Best,

                    Colleen

                  • March 12, 2013 at 2:29 am
                  Janner
                  Participant

                    I copied the stuff below from a Non-Hodgkin's Lymphoma page about the three drugs.  It may not directly translate to melanoma.  While Leukine is certainly used as an adjuvant treatment for melanoma (mixed results but it didn't seem to past muster as a melanoma therapy by itself), that may not make it the best choice for fixing neutropenia.  The other drugs might work better.  I think I'd probably go with whatever drug  my doctor recommended as they might be better at adjusting dosages and such for a drug they use all the time.  I have certainly seen others on this site post about taking Neupogen.  

                     

                     

                    Neupogen (Filgrastim)

                    Neupogen – Granulocyte Colony Stimulating Factor (or G-CSF) helps stimulate the production of Neutrophils. Neutrophils are the infection fighting white blood cells, so  Neupogen can help prevent chemotherapy induced neutropenia, and opportunistic infections. Its use during regular chemotherapy is not required, but often used anyway, especially for patients who already have compromised white cell counts.  During stem cell/bone marrow transplants it is almost 100% certain the patient will be given Neupogen injections. Injections are given daily, usually at the 5mcg per kilogram of body weight dose, for one week or longer. To read more about Neupogen click the link below.

                    http://www.neupogen.com/pi.html

                     

                    Neulasta (Peg-Filgrastim)

                    Neulasta is the once per chemotherapy cycle version of Neupogen. Instead of daily injections just one injection is required for each cycle of chemotherapy. For more information about Neulasta click the link below:

                    http://www.neulasta.com/patient/index.jsp

                     

                    Leukine (Sargramostim)

                    Similar to Neupogen, Leukine also stimulates the production of Neutrophils, but it goes one step further and also promotes the macrophages. Therefore it is called GM-CSF (Granuloctye Macrophage-Colony Stimulating Factor)  Recent studies have shown that for the purposes collecting enough CD34+ Stem Cells for transplant, Neupogen is more effective than Leukine, and Neupogen plus Leukine offers no additional benefit, but the cost is significantly higher. For more information about Leukine click the link below:

                    http://www.leukine.com

                    • March 12, 2013 at 5:46 pm
                    buckytom
                    Participant

                      After seeking a second opinion from Dr. Markovic at Mayo Clinic (he is their Melanoma doc) he recommended Leukin for my 3B diagnosis. His reasoning was the positive effects that they have had with the drug – even if there is a reoccurence it is limited and treatable. There are limited side effects compared to other treatments – and it is self administered. I have not yet started the treatment as I am in the middle of my radiation treatment and can not do both at the same time. I am due to start the Leukin in early April. 

                      • March 12, 2013 at 5:46 pm
                      buckytom
                      Participant

                        After seeking a second opinion from Dr. Markovic at Mayo Clinic (he is their Melanoma doc) he recommended Leukin for my 3B diagnosis. His reasoning was the positive effects that they have had with the drug – even if there is a reoccurence it is limited and treatable. There are limited side effects compared to other treatments – and it is self administered. I have not yet started the treatment as I am in the middle of my radiation treatment and can not do both at the same time. I am due to start the Leukin in early April. 

                          • March 12, 2013 at 7:06 pm
                          swissfarm7
                          Participant

                            Thanks for your reply, buckytom.  I'm sorry to hear of your diagnosis.  Sounds like even though you and my husband are both 3B, you're each following quite different courses of treatment. Proving once again that best management of this disease is anyone's guess. :-/

                            Take care,

                            Colleen

                            • March 12, 2013 at 7:06 pm
                            swissfarm7
                            Participant

                              Thanks for your reply, buckytom.  I'm sorry to hear of your diagnosis.  Sounds like even though you and my husband are both 3B, you're each following quite different courses of treatment. Proving once again that best management of this disease is anyone's guess. :-/

                              Take care,

                              Colleen

                              • March 12, 2013 at 7:06 pm
                              swissfarm7
                              Participant

                                Thanks for your reply, buckytom.  I'm sorry to hear of your diagnosis.  Sounds like even though you and my husband are both 3B, you're each following quite different courses of treatment. Proving once again that best management of this disease is anyone's guess. :-/

                                Take care,

                                Colleen

                              • March 12, 2013 at 5:46 pm
                              buckytom
                              Participant

                                After seeking a second opinion from Dr. Markovic at Mayo Clinic (he is their Melanoma doc) he recommended Leukin for my 3B diagnosis. His reasoning was the positive effects that they have had with the drug – even if there is a reoccurence it is limited and treatable. There are limited side effects compared to other treatments – and it is self administered. I have not yet started the treatment as I am in the middle of my radiation treatment and can not do both at the same time. I am due to start the Leukin in early April. 

                                • March 13, 2013 at 6:14 am
                                swissfarm7
                                Participant

                                  Any other takers?  I'd so appreciate more input on this…

                                  • March 13, 2013 at 6:14 am
                                  swissfarm7
                                  Participant

                                    Any other takers?  I'd so appreciate more input on this…

                                    • March 13, 2013 at 6:14 am
                                    swissfarm7
                                    Participant

                                      Any other takers?  I'd so appreciate more input on this…

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