Table 9

Actionable events in all steroid-sparing agents

EventAction
White blood cell count<3.5×109/LWithhold until discussion with lead clinician
Neutrophils<1.6×109/L
Unexplained eosinophilia>0.5×109/L
Platelets<140×109/L
Creatinine>30% above baseline or eGFR <60 mL/min/1.73 m2
ALT, AST>100 IU/L
Unexplained fall in serum albumin
Rash or oral ulceration
MCV>105 fLCheck and treat B12, folate, thyroid function. If normal, withhold until discussion with lead clinician
Abnormal bruising or severe sore throatWithhold until FBC available and discuss with lead clinician
  • ALT, alanine transaminase; AST, aspartate aminotransferase; eGFR, estimated glomerular filtration rate; FBC, full blood count; MCV, mean cell volume; WBC, white blood cell.