I am a retired RN, a 30 year breast cancer survivor, and the mother of a 30 something who has recently been diagnosed with breast cancer. I just finished an in depth 2 month study of everything I could find regarding breast cancer, chemo protocols, the drugs, etc. I think I have a decent handle on current trends in cancer science and treatment; however, something has happened that leaves me with questions I can't find answers for. My daughter [I'll call her Sarah] went for her second AC tx today by herself, and a medication error was made at the oncology unit. [Background: her children were off school today for teacher conferences; Sarah felt comfortable on her own, so I stayed back to care for the children at my house. After she left, I discovered that one of the kiddies was c/o of a sore throat with mildly elevated temp. of 100.2.]
Back to the oncology unit: The staff reviewed her labs prior to initiating tx, but actually looked at her labs from two weeks ago, rather than the labs done today - ie the day of tx. After infusing all of the Adriamycin dose and 3/4 of the cytoxan, the nurse discovered today's actual labs showing wbc's of 1.0 (1,000) prior to tx. The last 1/4 of cytoxan was dc'd, and the doctor was notified. The plan is for Sarah to receive Neupogen sq qd x 5 days, to complete a course of antibiotic tx with Cipro, and to present to a hospital ED if she develops a temp of 100. No other insructions were given.
I realize her risk based on the current neutopenia, the need for avoidance of crowded places, protection from people who may be ill, nutritional support and all that. I took Sarah's sick child to her doctor where she was dx with a strep throat infection, and was started on an antibiotic; the other children are disease free at this point. The children will stay with me for the next two days to protect Sarah from their infection.
My question is this: what can we expect in terms of recovery from the neutropenia (based on effect from the dose of AC she received today + the effect of the neupogen over the next 5 days)? One med site listed a precaution AGAINST giving neupogen within 24 hours of receiving cytoxan, so I am worried about that also - (Sarah says she received her first dose of neupogen today on the unit). Can anyone offer some experienced insight? Thanks.