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Myelosuppression as a result of Carboplatin treatment is closely related to the renal clearance of the drug. Therefore in patients who have abnormal renal function or who are receive concomitant therapy with nephrotoxic drugs, myelosuppression, especially thrombocytopenia, may be more severe and prolonged.
The occurrence, severity and protraction of toxicity is likely to be greater in patients who have received extensive prior treatment for their disease, have poor performance status and are more advance in age.
Renal function parameters should be assessed prior to, during and after therapy.
Peripheral blood counts (including platelets, white blood cells and haemoglobin) should be followed during and after therapy. Combination therapy with other myelosuppressive drugs may require modification of dosage and/or timing of schedules in order to minimize additive effects. Carboplatin courses should not, in general, be repeated more frequently than every four weeks in order to ensure that the nadir in blood counts has occurred and there has been recovery to a satisfactory level.
Mutagenicity: Carboplatin has been shown to be mutagenic in mammalian cells. Patients should be advised of its mutagenic potential and should use effective contraception for an adequate duration of time after ceasing therapy.
