[nurmac]

I am new to oncology nursing. One question that I have is when I set up a cycle of treatment, which particular chemo treatments do you automatically set up neupogen/neulasta injections. Which treatments always require neup/neulasta? Many pts, we wait and see how the chemo is going to affect them but sometimes the injections are scheduled without knowing how the wbc's will be effected.

[sggirl]

Dose dense Chemotherapy (q 2 weeks ex. Adriamycin/Cytoxan-Taxol and DD CHOP)always require Neulasta support. In the past, these regimens were only scheduled q 3 weeks because it would take at least 3 weeks for the wbc's to recovery. Neulasta allows patients to get their chemo every 2 weeks without delays due neutropenia. This allows for more aggressive therapies and better outcomes with shorter nadir.
Generally,with any chemotherapy that is at least 14 days apart, the pt can recieve Neulasta if the the doctor has noticed a pattern of nadir which delays scheduled chemo.
Where I work, the patients recieve Neupogen if their therapy is weekly and require WBC support to continue chemo as scheduled.
hope this helps.