| Hematology: for both drugs (103/mL) |
|
| Neutrophils (≥1.5) and platelets (≥90) |
100% |
| Neutrophils (1.0-1.49) or platelets (≥90) |
75% |
| Neutrophils (<1) or platelets (<100) |
Delay for 1 week (or longer if needed), till recovery, then give 75% dose, consider giving filgrastim for subsequent cycles |
| Febrile neutropenia |
75% of dose for current and subsequent cycles, use G-CSF for 1st episode, and 50% of dose for 2nd episode |
| Creatinine clearance: for cyclophosphamide |
|
| ≥10 |
100% |
| <10 |
75% |
| Hepatic function tests |
|
| For epirubicin |
|
| ALT (<2 ULN) and total bilirubin (≤1.17 mg/dL) |
100% |
| ALT (2-4× ULN) and total bilirubin (1.23-2.92 mg/dL) |
50% |
| ALT (>4× ULN) and total bilirubin (>2.92 mg/dL) |
25% |
| For docetaxel |
|
| ALT/AST (<1.5× ULN) and alkaline phosphatase (<2.5× UNL) |
100 mg/m2
|
| ALT/AST (1.5-3.5 ULN) and alkaline phosphatase (2.5-6× UNL) |
75 mg/m2
|
| ALT/AST (>3.5× ULN), total bilirubin (>ULN) and alkaline phosphatase (>6× UNL) |
Avoid use |
| Dose modification for other toxicities |
|
| ≥grade 3 non-hematologic toxicities |
Paclitaxel dose: hold treatment, re-evaluate treatment plan, consider discontinuing treatment with this protocol |
