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Bone marrow suppression (primarily neutropenia) is dose dependent and is dose-limiting toxicity. Nanoxel should not be administered to patients with baseline neutrophil counts of < 1500 cells/mm3. Frequent monitoring of blood counts should be instituted during Nanoxel treatment. Patients should not be retreated with subsequent cycles of Nanoxel until neutrophils recover to a level of >1500 cells/mm3 and platelet recover to a level >100,000 cells/mm3.
The use of Nanoxel has not been studied in patients with hepatic or renal dysfunction.
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