My husband did his stem cell collection Sept 10-12 and had the cells frozen for later transplant.
He took 3 days to collect enough cells, and was given not just the 4 single doses of GCSF [Neupogen, filgrastim], but 3 days of double doses.
His WBC were through the roof - 51 - 55 compared to a normal of 5-6.
The last two kidney function and creatinine tests have been lousy.
Sep 17 was e-GRF 48 Creatine 130
Sep 30 was e-GRF 43 Creatine 142
His numbers had been in the normal ranges before this, and he had no problem with his light chains in the testing pre-collection.
Could the enormous dump of white blood cells have caused the kidney function decrease, and how long would that normally take to clear? His WBC is back to normal.
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LisaE - Name: Lisa
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: April 2014
- Age at diagnosis: 67
Re: GCSF (Neupogen, filgrastim) and kidneys
Hi LisaE,
It sounds like your husband collected well, which is good news!
It is hard for me to interpret the kidney function values you provide - creatinine values are most often reported in mg/dl. What units are the values you have provided in?
Regardless, to answer your question about the association between the increase of cells and kidney function, indeed in animal models it has been shown that in animals who already have poor kidney function, mobilizing stem cells made that worse. However, in animals without pre-existing kidney injury, there was not kidney injury with mobilizing stem cells. And in practice, we do not see a lot of kidney injury during collection. Not to say that it can't happen.
What does your husband's doctor say? Is he/she worried?
Wish I could be more help!
It sounds like your husband collected well, which is good news!
It is hard for me to interpret the kidney function values you provide - creatinine values are most often reported in mg/dl. What units are the values you have provided in?
Regardless, to answer your question about the association between the increase of cells and kidney function, indeed in animal models it has been shown that in animals who already have poor kidney function, mobilizing stem cells made that worse. However, in animals without pre-existing kidney injury, there was not kidney injury with mobilizing stem cells. And in practice, we do not see a lot of kidney injury during collection. Not to say that it can't happen.
What does your husband's doctor say? Is he/she worried?
Wish I could be more help!
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Dr. Heather Landau - Name: Heather Landau, M.D.
Beacon Medical Advisor
Re: GCSF (Neupogen, filgrastim) and kidneys
He actually had a rough time of collection. He produced huge amounts of WBC, but he just barely produced enough stem cells over 3 full days with double doses of GCSF. It is good news that he's done with it and the cells are sitting in a freezer 
His kidney function had been quite good, but when he started having lung problems (the current theory from our doctors is Cytoxan toxicity), his kidney function began going down as well. It was back in normal ranges when he came off chemo for to rest before collection, then decreased dramatically afterwards.
In Canada we report in units per litre. His creatinine is at 14.2 in units per dl.
I put the question to our doctor right before I posted here and am waiting for a response. I'll post it when I hear back.
Thanks,
Lisa
His kidney function had been quite good, but when he started having lung problems (the current theory from our doctors is Cytoxan toxicity), his kidney function began going down as well. It was back in normal ranges when he came off chemo for to rest before collection, then decreased dramatically afterwards.
In Canada we report in units per litre. His creatinine is at 14.2 in units per dl.
I put the question to our doctor right before I posted here and am waiting for a response. I'll post it when I hear back.
Thanks,
Lisa
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LisaE - Name: Lisa
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: April 2014
- Age at diagnosis: 67
Re: GCSF (Neupogen, filgrastim) and kidneys
Hi Lisa,
Thanks for the follow up.
If the creatinine units are reported per liter, then could you double check to see if they are mg/liter, or perhaps mmol/liter (micromoles per liter)?
A reference (normal) range for serum creatinine of 0.6 to 1.3 milligrams per deciliter (mg/dL) translates to a reference range of 53 to 115 micromoles per liter (mmol/L). So, although it doesn't make a big difference, you can't just divide results reported in mmol/L by 10 to get the mg/dL equivalent. It's close, but not quite right.
Glad to hear that your husband collected enough stem cells!
Thanks for the follow up.
If the creatinine units are reported per liter, then could you double check to see if they are mg/liter, or perhaps mmol/liter (micromoles per liter)?
A reference (normal) range for serum creatinine of 0.6 to 1.3 milligrams per deciliter (mg/dL) translates to a reference range of 53 to 115 micromoles per liter (mmol/L). So, although it doesn't make a big difference, you can't just divide results reported in mmol/L by 10 to get the mg/dL equivalent. It's close, but not quite right.
Glad to hear that your husband collected enough stem cells!
Re: GCSF (Neupogen, filgrastim) and kidneys
The measurement is in umol/L.
Why that unit I cannot tell you We're strange up here.
Why that unit I cannot tell you
We're strange up here.-
LisaE - Name: Lisa
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: April 2014
- Age at diagnosis: 67
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