In addition, monitor a platelet count, liver enzymes, and bilirubin prior to each CCNU administration. Thrombocytopenia occurs 21 days following administration.
Platelet count should be checked prior to administration of therapy.
If the ALT is higher than the ALP, if there is a tremendous increase in these values from the last treatment, if the GGT has increased since last visit, or if there is a hyperbilirubinemia, postpone therapy for 2 weeks and recheck.
If there is CCNU toxicity, the values typically decrease.
Subsequent doses should be given at larger intervals typically every 6 weeks. Diuresis at Continue this cycle for one year. Begin to wean the patient off the prednisone after 12 months.
Every one to two weeks, a CBC should be checked. A CBC should be performed prior to each treatment, if the neutrophils are less thanwait days and repeat CBC.
If sterile hemorrhagic cystitis occurs on cyclophosphamide, discontinue and switch to Chlorambucin 1. Evaluation of a six-month protocol with no maintenance therapy for dogs with lymphoma.