Dose modifications for hematologic toxicity
For Plt count < 100 × 109/L or ANC < 1.5 × 109/L | For Plt count < 75 × 109/L or ANC < 1.25 × 109/L | For Plt count < 50 × 109/L or ANC < 1.0 × 109/L |
| ↓ | ↓ | ↓ |
| Hold Ara-C | Hold Ara-C | Hold Ara-C |
| Continue imatinib mesylate | Continue imatinib mesylate | Hold imatinib mesylate |
| ↓ | ↓ | ↓ |
| Blood counts weekly | Blood counts weekly | Blood counts weekly |
| ↓ | ↓ | ↓ |
| Start next Ara-C cycle when | Start next Ara-C cycle | Start imatinib mesylate when |
| Plt count > 100 × 109/L and ANC > 1.5 × 109/L | 2 weeks after | Plt count > 100 × 109/L and ANC > 1.5 × 109/L |
| Plt count > 100 × 109/L and ANC > 1.5 × 109/L | Start next Ara-C cycle | |
| at a 50% dose reduction | 2 weeks later at a 50% dose reduction | |
| (to 10 mg/m2 with first occurrence, then 5 mg/m2) | (to 10 mg/m2 with first occurrence, then 5 mg/m2) |
For Plt count < 100 × 109/L or ANC < 1.5 × 109/L | For Plt count < 75 × 109/L or ANC < 1.25 × 109/L | For Plt count < 50 × 109/L or ANC < 1.0 × 109/L |
| ↓ | ↓ | ↓ |
| Hold Ara-C | Hold Ara-C | Hold Ara-C |
| Continue imatinib mesylate | Continue imatinib mesylate | Hold imatinib mesylate |
| ↓ | ↓ | ↓ |
| Blood counts weekly | Blood counts weekly | Blood counts weekly |
| ↓ | ↓ | ↓ |
| Start next Ara-C cycle when | Start next Ara-C cycle | Start imatinib mesylate when |
| Plt count > 100 × 109/L and ANC > 1.5 × 109/L | 2 weeks after | Plt count > 100 × 109/L and ANC > 1.5 × 109/L |
| Plt count > 100 × 109/L and ANC > 1.5 × 109/L | Start next Ara-C cycle | |
| at a 50% dose reduction | 2 weeks later at a 50% dose reduction | |
| (to 10 mg/m2 with first occurrence, then 5 mg/m2) | (to 10 mg/m2 with first occurrence, then 5 mg/m2) |
If Ara-C dose of 5 mg/m2 was unable to be administered, then imatinib mesylate was reduced to 300 mg/d. If Ara-C was unable to be administered at this dose, then imatinib mesylate was given at a dose of 300 mg/d and Ara-C was discontinued permanently.
Plt indicates platelets; ANC, absolute neutrophil count.