The most common grade 3 and 4 toxic effects-which were all more common with doxorubicin and ifosfamide than with doxorubicin alone-were leucopenia ( 97 [ 43 % ] of 224 patients vs 40 [ 18 % ] of 223 patients ) , neutropenia ( 93 [ 42 % ] vs 83 [ 37 % ] ) , febrile neutropenia ( 103 ( 46 % ) vs 30 [ 13 % ] ) , anaemia ( 78 [ 35 % ] vs 10 [ 5 % ] ) , and thrombocytopenia ( 75 [ 33 % ] ) vs one [ < 1 % ] ) .