chemo and low platelets

After 13 months of chemo, my bone marrow shutdown and I needed platelet transfusions every week to 10 days. Diagnosed with stage 3 ovarian cancer 12/05. Platelets got as low as six thousand.  Now after nine months it appears bone marrow is again making platelets as my last count was 209,000.  Week before it was 115,000.  Is it possible I could once again get some chemo to slow the grown of my tumor.  My last ca 125 was 3416. Other than some digestive problems and hard to move bowels I am feeling very well.  Would like to see if this cancer could be slowed with additional chemo.  Would this be possible with my history of platelet problems.

[Annekathryn Goodman, M.D.]

Dear Joyce,
You can receive more chemotherapy. It will be important for your doctor to be very careful with drug choices. It will also be necessary to consider some creative dose schedules of drugs.

All chemotherapy impacts the bone marrow to some degree. Certain drugs are known to drop the platelet counts more than others. For instance at standard doses these drugs can cause severe drops in the platelets:
gemzar
topotecan
carboplatin

However, you should consider low doses of certain chemotherapy drugs given more frequently such as:

cisplatin, taxol, doxil
even oral cytoxan which can lower platelet counts can be given safely.
example 50 mg orally per day

additionally if it is available at your hospital, combining chemo with a biologic agent may be reasonable. This is experimental at this time:

example: oral cytoxan with avastin
or low does weekly taxol with avastin

best wishes