A health care provider is evaluating the results of hematologic studies for a patient with cancer receiving busulfan (Myleran). Which of the following laboratory results would indicate that the patient is tolerating the drug?
a. Absolute neutrophil count (ANC) of 4500/mm3
b. Platelet count of 40,000/mm3
c. Blood urea nitrogen (BUN) of 18 mg/dL
d. Hematocrit of 28 mg/dL
ANS: A
Alkylating drugs such as busulfan cause bone marrow suppression; therefore platelet counts less than 50,000/mm3 and hemoglobin values 11 mg/dL necessitate attention and will likely cause antineoplastic therapy to be withheld. A normal leukocyte count is 4000 to 10,000 cells/mm3. A patient is neutropenic if his or her ANC is 1000 cells/mm3. The frequency of infection increases as the ANC falls below 500 cells/mm3 as well as the longer the patient remains neutropenic.
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