Navitoclax blocks three proteins cells use to stay alive; worn-out senescent cells depend on two. In animals it clears them and restores aged stem cells; in people this has never been measured — every human result comes from cancer medicine. Platelet counts fall in proportion to the dose, capping how much can be administered. Not approved anywhere, available only in trials. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Platelet count | 200–400 × 10⁹/L; hold below 75 × 10⁹/L | Dose-limiting on-target toxicity |
| Absolute neutrophil count | 2.0–5.0 × 10⁹/L | Infection risk from progenitor loss |
| Absolute lymphocyte count | 1.5–3.0 × 10⁹/L | B- and T-cell depletion from BCL-2 inhibition |
| Haemoglobin | 14.0–15.0 g/dL (men); 13.0–14.0 g/dL (women) | Detects anaemia, common in combination use |
| Alanine aminotransferase (ALT) | Below 25 U/L (men); below 20 U/L (women) | Dose-limiting liver enzyme rise |
| Aspartate aminotransferase (AST) | Below 25 U/L | Confirms hepatic origin when alanine aminotransferase rises |
| Total bilirubin | 0.3–1.0 mg/dL | Detects impaired bile handling |
| Estimated glomerular filtration rate (eGFR) | Above 90 mL/min/1.73 m² | Protocol entry requirement and safety floor |
| Immunoglobulin M | 40–230 mg/dL | Tracks the sustained B-cell deficit |
| Senescent-cell burden (p16INK4a expression) | No established target exists; track change from the individual's own baseline | Gauges whether senolysis actually occurred |
Cadence: Weekly during dose escalation, then every two weeks to week 8, then monthly; liver enzymes at weeks 2 and 4; immunoglobulins every 3 months; spleen and disease response at week 24 and every 12 weeks thereafter