Dose adjustment based on nadir count Platelets (x 109/l) ANC (x 109/l) Action ~ 25 with no bleeding and ~ 0.5 or < 0.5 for < 7 days No change < 25 or < 50 with bleeding and/or < 0.5 for > 7 days Dose reduction (see below) Any and < 0.5 and fever Dose reduction Recurrence of any of the above after 2 dose reductions Off study