Combating neutropenia, etc.

[JP100]

My mom, 74 and in otherwise good health, is 7 weeks post-TAH-BSO with Stg 3 / G3 serous papillary adenocarcinoma of the ovary that was declared optimally resected with no visible residual disease.

She began an IV carboplatin / paclitaxel 6-course regimen on 12/4 at 880 / 270mg which was well tolerated but prompted thrombocytopenia as low as 15k (requiring platelet transfusion) and neutropenia to < 2.0 which was aided briefly by neupogen. She feels well and wants to return to her full-time position.

Today she reported for treatment #2 at 32 days since #1 but while platelets were nearly 300k (fortunately; they say neumega just doesn't work) her white count was just 2.5; they said the ANC was just too low and sent her on her way to wait another week before trying again (they did give her procrit (Hgb was 11, crit 32)).

We're very concerned about the delay in what should be an every-three-week regimen and the dose reduction we've been told to expect on the next attempt. Is there more that can be done to help the blood counts recover, and / or is the delay less an obstacle to effective treatment than we've been led to believe? Please accept our gratitude for your time and recommendations.