Bone marrow suppression (neutropenia, thrombocytopenia and anemia) is common. Rash, toxic skin reactions and bullous exanthema may occur, and may be progressive or worsen with continued treatment. Infusion reactions, which may include chills, fever, pruritus, and rash, are common; rarely, anaphylactic and anaphylactoid reactions have occurred. Infections, including pneumonia and sepsis reported. Tumor lysis syndrome may occur (may lead to life-threatening acute renal failure). Use is not recommended with renal impairment (CrCl <40 mL/minute) or moderate (AST or ALT 2.5-10 times ULN and total bilirubin 1.5-3 times ULN)/severe (total bilirubin >3 times ULN) hepatic impairment.