I’ve been injecting Leukine in preparation for stem cell collection. As is usual for me, I’ve searched the web for as much information as I can find about it, and found this comment from the Non Hodgkin’s Lymphoma Cyberfamily web site to be disconcerting:
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
I plan on looking for the studies mentioned, so I can ask my doctor about the choice to use Leukine (5 days) and Neupogen (3 days).
On Thursday, when I started, I went to my local oncologist’s office, where one of the nurses showed me how to prepare the injection. Before, I had pre-filled syringes. I thought I was paying attention, but yesterday it became apparent that I hadn’t been. I remembered Andrea telling me to use a different needle to puncture the vial and withdraw the fluid, which I did. The needle is dulled when it goes through the top of the vial, so the injection hurts more. I can vouch for that. I had a heck of a time getting the Leukine into the syringe. It felt like there was a vacuum in there, and I got nothing but air. I ran over to my neighbor’s house to ask for help (she’s a nurse), but she wasn’t home. Her husband got her on the phone, and she told me to try taking the syringe out and putting it back in and injecting air into the bottle before trying to extract the med. That kind of worked. I was able to get some of the Leukine into the syringe. Some of it bubbled up out of the top of the vial. The needle wasn’t long enough to get it all out it seemed. I think it has something to do with the vacuum effect, and I just didn’t have that bit mastered. I gave myself a shot, and then managed to stab myself in the left middle finger when I was putting the cover back on the needle. I should have pushed the plunger in case there was any Lekine left in the syringe, but all I could do was swear and jerk it back. Anyway, my neighbor said she would help if I needed her. I could ask her to load the remaining 3 syringes for me. The injection part is really easy.
I had a bone marrow biopsy Monday. I have to say, it was the best one I ever had. That sounds weird, I know, but it’s true. I was told to take a few percocet tablets beforehand and I had some IV Ativan. I don’t remember the trip home. :)