SC Recommended starting dose for 1st treatment cycle: 75 mg/m
2 daily for 7 days, followed by a rest period of 21 days (28-day treatment cycle). Min: 6 cycles.
Patient w/o reduced baseline blood counts (ie, WBC ≥3.0 × 109/L, ANC ≥1.5 × 109/L & platelets ≥75.0 × 109/L) prior to 1st treatment If haematological toxicity is observed following treatment, delay next therapy cycle until platelet count & ANC recovered. No dose adjustment is necessary if recovery is achieved w/in 14 days. Reduce dose if recovery is not achieved w/in 14 days. Cycle duration should return to 28 days following dose modifications.
Patient w/ reduced baseline blood counts (ie, WBC <3.0 × 109/L, ANC <1.5 × 109/L or platelets <75.0 x 109/L) prior to 1st treatment Following treatment, if the decrease in WBC, ANC or platelets from that prior to treatment is ≤50% or >50% but w/ an improvement in any cell line differentiation, next cycle should not be delayed & no dose adjustment. If the decrease in WBC, ANC or platelets is >50% from that prior to treatment, w/ no improvement in cell line differentiation, delay next therapy cycle until platelet count & ANC recovered. No dose adjustment is necessary if recovery is achieved w/in 14 days. Determine bone marrow cellularity if recovery is not achieved w/in 14 days. No dose adjustment if bone marrow cellularity is >50%. Delay treatment & reduce dose if bone marrow cellularity is ≤50%. Cycle duration should return to 28 days following dose modifications.
Renal impairment Reduce dose by 50% on the next cycle if unexplained reduction in serum bicarbonate levels to <20 mmol/L occur. Delay next cycle until values return to normal or baseline & reduce dose by 50% on the next treatment cycle if unexplained elevations in serum creatinine or BUN to ≥2-fold above baseline values & ULN occur.
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