Hi Dyana
Wendy is out for a bit. As you know, when we see this kind of pattern, we can fast track by raising the dose by 0.25u every four cycles. The TR protocol does state the dose should be raised by 0.5u after six cycles if nadirs are greater than 300 and he’s pretty much there. Plus, as Wendy said, when we get to 5u, we start increasing by 0.5u after every six cycles. So our goal with him right now for where his nadirs and his dose are, is to increase by 0.5u after every six cycles until we see better numbers.
That was kind of a summary for how we can do things and because we CAN increase after four cycles with these kinds of nadirs, I think it is reasonable to increase him to 5.5u in the morning and then after six cycles, if he’s not seeing much better nadirs, you are correct the next increase would be to 6u bid.
Good luck with the increase. And Jackson.....don’t eat so much!!!