The most common drug-related adverse events for patients treated with trabectedin were nausea ( 32 [ 89 % ] of 36 ) , decreased appetite ( 21 [ 58 % ] ) , decreased neutrophil count ( 30 [ 83 % ] ) , increased alanine aminotransferase ( 24 [ 67 % ] ) , and decreased white blood cell count ( 20 [ 56 % ] ) .