Chemotherapy dose modification scheme
| Dosing condition . | Dosing adjustment . |
|---|---|
| Cycle 1 | No reduction allowed |
| Following cycles (if no episode of febrile granulocytopenia) and absolute granulocyte count (AGC) ≥ 1.9 × 109/L and platelet count ≥ 75 × 109/L at day of retreatment | No dose reduction |
| AGC 1.5-1.8 × 109/L or platelet count 50-74 × 109/L | Cyclophosphamide, doxorubicin/mitoxantrone reduced to 75% of full dose |
| AGC <1.5 × 109/L or platelet count < 50 × 109/L | Delayed treatment until AGC ≥ 1.5 × 109/L and platelet count ≥ 50 × 109/L; doses as above |
| If episode of fever/infection during granulocytopenia Following two such episodes, remaining cycles were to be modified as below. | Doses as below |
| AGC ≥1.9 × 109/L and platelet count ≥75 × 109/L | Cyclophosphamide, doxorubicin/mitoxantrone reduced to 75% of full dose |
| AGC < 1.9 × 109/L or platelet count < 75 × 109/L | Delayed treatment until AGC ≥ 1.9 × 109/L and platelet count ≥ 75 × 109/L; doses as above |
| Dosing condition . | Dosing adjustment . |
|---|---|
| Cycle 1 | No reduction allowed |
| Following cycles (if no episode of febrile granulocytopenia) and absolute granulocyte count (AGC) ≥ 1.9 × 109/L and platelet count ≥ 75 × 109/L at day of retreatment | No dose reduction |
| AGC 1.5-1.8 × 109/L or platelet count 50-74 × 109/L | Cyclophosphamide, doxorubicin/mitoxantrone reduced to 75% of full dose |
| AGC <1.5 × 109/L or platelet count < 50 × 109/L | Delayed treatment until AGC ≥ 1.5 × 109/L and platelet count ≥ 50 × 109/L; doses as above |
| If episode of fever/infection during granulocytopenia Following two such episodes, remaining cycles were to be modified as below. | Doses as below |
| AGC ≥1.9 × 109/L and platelet count ≥75 × 109/L | Cyclophosphamide, doxorubicin/mitoxantrone reduced to 75% of full dose |
| AGC < 1.9 × 109/L or platelet count < 75 × 109/L | Delayed treatment until AGC ≥ 1.9 × 109/L and platelet count ≥ 75 × 109/L; doses as above |
If an additional febrile episode was recorded despite dose reduction, remaining courses were to be given at 60% (cyclophosphamide, doxorubicin, mitoxantrone). If the delay exceeded 3 weeks, the patient was withdrawn from the study.