Parameters:
(1) granulocyte count on the day of therapy
(2) history of previous granulocyte counts
(3) history of fever and/or sepsis
(4) total serum bilirubin
Adjustments for Hematologic Toxicity
Causes for further reductions include:
(1) presence of fever and/or sepsis while granulocytopenic
(2) previous 2 weeks had dose held for granulocytopenia
|
Granulocyte Count
|
Percent of Starting Dose to Administer
|
Causes for Further Reductions
|
|
>= 1,500 per µL
|
100%
|
75%
|
|
1,000 - 1,499 per µL
|
50%
|
37.5%
|
|
< 1,000 per µL
|
hold dose
|
hold dose
|
If the dose is held for 3 weeks in a row, then discontinue the vinorelbine.
Adjustments for Hepatic Toxicity
|
Total Serum Bilirubin
|
Percentage of Starting Dose
|
|
<= 2.0 mg/dL
|
100%
|
|
2.1 - 3.0 mg/dL
|
50%
|
|
> 3.0 mg/dL
|
25%
|
Adjustments for Mixed Hematologic and Hepatic Toxicity
If both hematologic and hepatic toxicity are present, then the lower of the 2 dosage adjustments should be used.
