Kadcyla and low platelets - need your advice please

[toothfilla]

Hello everyone,

My mother started Kadcyla a couple months ago.
After her first dosage the platelets were fine, but after the second dosage they dropped way down to 10k. She was given a transfusion and according to the kadcyla rx info, the doc had her wait until she returned to above 75k to give the next dosage. Unfortunately, that meant that instead of getting her dosage 3 weeks later, she had to wait 6 weeks and they did a dose reduction.

After the dose reduction, she only dipped to 35k at 8-9 days (nadir) and we just checked today and she is still only at 40k. Next dose would be normally scheduled for this Saturday (3 weeks) but now we are trying to figure out what to do.

My mother is being treated overseas and she is one of the first there to get Kadcyla so the docs don't have a lot of experience with it.

I'm hoping someone in a similar situation could chime in on what they did and what their doc modified.

Should we:

1. Give another platelet transfusion (and perhaps give it each time?) until the number goes above 75k? Her doc currently doesn't want to give transfusions and said it should be allowed to rise on its own.

2. Wait until the count is 75k without administering any further platelet transfusions?

3. Do something else?

I really hope some Kadcyla patients are in a similar situation and can chime in.