Postoperative chemotherapy is an important method for preventing malignancy** and metastasis. However, chemotherapy often causes bone marrow suppression, resulting in a decrease in the number of white blood cells. Since white blood cells are key to the body's fight against disease, leukopenia can trigger infections with serious and even life-threatening consequences.
Therefore, it is often necessary to use "white needles" in clinical practice to help complete chemotherapy smoothly and avoid serious consequences due to insufficient white blood cells. However, many patients have some misconceptions and misunderstandings about "white needles".
Q: How much do you know about the "white needle"?
"Whitening needle" is an injection, the main ingredient of which is recombinant human granulocyte colony-stimulating factor, which can increase the number of white blood cells (mainly neutrophils) by stimulating the production of hematopoietic cells in the bone marrow, thereby achieving the purpose of raising white blood cells. Chemotherapy is an indispensable anti-tumor** method, but leukopenia is one of the most common***.
Leukopenia may lead to a decrease in immunity, making patients susceptible to infections. To prevent or alleviate chemotherapy-induced leukopenia, patients usually need to receive injections called "white needles". This can help increase the number of white blood cells, strengthen immunity, and avoid infections.
Q: Which patients can be considered for a white needle injection?
1.Chemotherapy-naïve patients: patients are evaluated according to the chemotherapy regimen and prophylactic medication is indicated if the patient is expected to be at high risk of neutropenia during chemotherapy.
2.Patients who are not chemotherapy-naïve: prophylactic medication is indicated if the patient develops neutropenic complications (e.g., fever, infection, etc.) after the previous course of therapy (without prophylactic whitening needle) and reducing the dose of chemotherapy may affect efficacy.
It is important to note that the use of white needles for prophylaxis before chemotherapy is not recommended.
This is because naïve leukocytes released or reborn after the white needle are not yet mature and are more sensitive to cytotoxic chemotherapy drugs, which can lead to more severe bone marrow suppression and difficulty in recovery.
The use of white needles before chemotherapy is mainly to increase the number of white blood cells in the short term to ensure that chemotherapy is carried out on time.
Q: What is the difference between a "long-acting" whitening needle and a "short-acting" whitening needle?
Long-acting whitening injection is a prophylactic drug that can be used on the second or third day of chemotherapy, and its effects can last up to two weeks, requiring only one injection, during which there is no longer a need for a follow-up of white blood cells, only a test before the next chemotherapy.
However, long-acting white injection is a category B drug under medical insurance, and the reimbursement condition is "limited to patients with severe neutropenia and fever in the previous chemotherapy process**" (the specific reimbursement conditions may vary by region).
If they are not eligible for reimbursement, they need to purchase them at their own expense, which is about 1,700 yuan per vial. The short-acting whitening needle, also known as the "rescue whitening needle", requires a routine blood test every 2-3 days because of its short-lasting effect, and if the white blood cells are still low, the injection is continued until the white blood cells return to normal or close to normal levels. However, short-acting whitening injections also have significant drawbacks, mainly the hassle and need for close monitoring of the blood routine.
If the white blood cells are lower than normal and the white blood cells cannot be injected in time, the patient is prone to infection. In contrast, short-acting whitening injections are cheaper, about 80 yuan per injection, and the use history is longer than long-acting whitening injections. Therefore, in general, doctors usually recommend patients to use short-acting whitening injections. Which of the following is the characteristic of short-acting whitening needle?a.Cheap but troublesome bExpensive but convenient, everyone is welcome to leave an answer in the comment area
Q: Under what circumstances is it recommended to use long-acting white needles?
1.Observation of the previous course of chemotherapy: If the patient's white blood cell levels were severely reduced during the previous course, long-acting whitening needles may be considered to prevent another severe leukopenia in the next course.
2.Patients with poor constitution or age: To avoid infection or other conditions after leukopenia, long-acting whitening needles are recommended for these patients.
3.Patients who have recently undergone surgery or have open wounds: The use of long-acting whitening needles in these patients can prevent infection and promote wound healing.
4.Patients with high intensity of chemotherapy regimens: long-acting whitening needles are recommended for patients with high intensity chemotherapy regimens that may result in an increased risk of leukopenia and may be more severe.
Q: Is it important if the white blood cells are too high after using the white needle?Leukocyte hypersensitivity occurs after the use of whitening needles, mainly due to the stimulation of bone marrow granulogranular hematopoiesis. This situation generally does not require special treatment.
Once the whitening needle is stopped, the stimulating effect on the bone marrow disappears, and the bone marrow stops producing white blood cells in large quantities. At the same time, the white blood cells that have formed will enter the process of aging and apoptosis after a few days, so that the white blood cells will quickly return to normal levels. The doctor will observe and evaluate the patient's specific situation, and if necessary, take appropriate measures.
In general, high white blood cells are a temporary phenomenon that returns to normal on their own over time.
Q: Can the white needle be used at the same time as chemotherapy drugs?
Due to the potential sensitivity of rapid** bone marrow cells to cytotoxic chemotherapy drugs, proliferating hematopoietic cells may be damaged by cytotoxic drugs if the white needle is given on the same day or immediately before chemotherapy, resulting in a more severe degree of myelosuppression.
Therefore, it is necessary to pay attention to the time interval between G-CSF and chemotherapy in the time of administration, and avoid using G-CSF at the same time or immediately after chemotherapy. The general recommended interval is 24-48 hours. That is, after G-CSF, wait 24-48 hours before chemotherapyAfter chemotherapy, you also need to wait 24-48 hours before giving G-CSF.
Such a time interval can be arranged to minimize the degree of myelosuppression by preventing hematopoietic cells from being overly sensitive to chemotherapy. According to the specific situation of the patient, the doctor will arrange the time interval between the white needle and chemotherapy according to the above principles.
Q: What are the adverse effects of using Lbaining needles?
1.Bone pain: It mainly appears in the lumbosacral region, the degree varies from person to person, and it will generally be relieved after stopping the drug.
2.Digestive tract reactions: including nausea, vomiting, constipation, and loss of appetite.
3.High fever and rash: Some patients may present with fever and rash, also known as neutrophilic dermatitis.
4.Spleen rupture: there have been reports of possible splenic rupture, some of which are fatal, mainly in patients with underlying hematopoietic dysfunction or solid tumors. However, these reports are only anecdotal, but caution is needed to seek immediate medical attention if signs or symptoms are suspicious.
5.Allergic reactions: Since the white needle is a biological agent, there is a possibility of allergic reactions, and it should be closely observed after use.
In conclusion, we should apply the whitening needle scientifically and reasonably: on the one hand, we should oppose the abuse of the whitening needle to avoid increasing the worry and pain of patients.
Liter white needles should be used when appropriate, depending on the patient's specific situation and the needs of the chemotherapy regimen.
On the other hand, the idea that the white needle is harmful is rejected is opposed. These perspectives ignore the important role of whitening needles in preventing and managing leukopenia, and only put patients in a more dangerous situation.
L-white needle is a clinically proven and widely used drug that is safe and effective when used appropriately.
Therefore, we need to make scientific judgment and rational application of whitening needles according to the doctor's advice and the actual situation of the patient, so as to minimize the risk of leukopenia and improve the efficacy and quality of life of patients.
Healthy Wintering Program