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Perth Haematology :: Dr Steven Ward

Chemotherapy Protocols

NHL Hodgkin Myeloma Autograft AML/ALL

 

G1                      
G2                      
G3                      
G4                      
                     
 NHL Drug Dose Days Notes Nausea Neutropenia Thrombocytopenia Mucositis Other Renal Dis Liver Dis
CHOP Cyclophosphamide IV 750mg/m2 1 NS 1L 1h G3 G3 Rare G1 Cardiac Function - Doxo    
R-CHOP Doxorubicin IVB 50mg/m2 1           Vesicant - Vinc, Doxo    
every 14 or 21 days Vincristine IVB 1.4mg/m2 1           Neuropathy - Vinc    
6-8 cycles Prednisolone oral 100mg/d 1-5                
  Rituximab IV 375mg/m2 1                
Chl-Pred Chlorambucil oral 10mg 1-5   G1 Dose rel Dose rel     Increased myleosupn  
every 28 days Prednisolone oral 1mg/kg 1-5     (G2)          
Cyclo-Pred Cyclophosphamide oral 150mg/m2 1-5                
every 28 days Prednisolone oral 1.5mg/kg 1-5                
MCP Mitozantrone IV 14mg/m2 1                
every 28 days Chlorambucil oral 10mg 1-5                
  Prednisolone oral 1mg/kg 1-5                
CVP Cyclophosphamide IV 750mg/m2 1   G3 G3 Rare Rare Neuropathy - Vinc    
R-CVP Vincristine IVB 1.4mg/m2 1           Vesicant - Vinc     
every 21 days Prednisolone oral 2mg/kg 1-5                
6-8 cycles Rituximab IV 375mg/m2 1                
DHAC Dexamathasone oral/iv 40mg 1-4   G3 G4 G4 G2 ? TLS cycle 1 reduce Carbo  
R-DHAC Cytarabine IV bd 2g/m2 2 2 doses 12h apart         Steroid eye drops - (cytarabine) G2 renal tox in 20%  
28 days Carboplatin IV 200mg/m2 1-3                
1-4 cycles Rituximab IV 375mg/m2 4                
Hi-dICE Ifosfamide IV 5g/m2 2   G4 G4 G3 G2 Encephalopathy - Ifos Reduce Etop  
R-Hi-dICE MESNA IV 5g/m2 2           Haematuria - Ifos (MESNA)    
3 weeks MESNA IV 1g/m2 3                
2+ cycles Carboplatin IV AUC 5 2                
  Etoposide IV 100mg/m2 1-3                
  Rituximab IV 375mg/m2 3                
Hi-dICE OP Ifosfamide IV 1.67g/m2 1-3   G4 G4 G3 G2 Encephalopathy - Ifos Reduce Etop  
R-Hi-dICE OP MESNA iv 400mg/m2 1-3           Haematuria - Ifos (MESNA)    
3 weeks MESNA oral @ 4 & 8 hrs 670mg/m2 1-3 400 or 600mg tabs              
Carboplatin IV AUC 5 2                
  Etoposide IV 100mg/m2 1-3                
  Rituximab IV 375mg/m2 3                
FC Fludarabine  oral 45mg/m2 1-3   G3 G3 G3 G1 1st dose effect - Rituximab Flud C/I in RnF  
FCR Cyclophosphamide oral 250mg/m2 1-3           TLS - esp CLL (1st dose)    
28 days Rituximab IV 375mg/m2 3           Very immunsuppressive    

 

 

 

 

 

 NHL Drug Dose Days Notes            
CHOP Cyclophosphamide IV 750mg/m2 1 NS 1L 1h            
R-CHOP Doxorubicin IVB 50mg/m2 1              
14 or 21 days Vincristine IVB 1.4mg/m2 1              
Prednisolone oral 100mg/d 1-5
  Rituximab IV 375mg/m2 1              
Chl-Pred Chlorambucil oral 10mg 1-5
28 days Prednisolone oral 1mg/kg 1-5              
Cyclo-Pred Cyclophosphamide oral 150mg/m2 1-5              
28 days Prednisolone oral 1.5mg/kg 1-5              
MCP Mitozantrone IV 14mg/m2 1              
28 days Chlorambucil oral 10mg 1-5
  Prednisolone oral 1mg/kg 1-5              
CVP Cyclophosphamide IV 750mg/m2 1              
R-CVP Vincristine IVB 1.4mg/m2 1              
21 days Prednisolone oral 2mg/kg 1-5
  Rituximab IV 375mg/m2 1              
DHAC Dexamathasone oral/iv 40mg 1-4
R-DHAC Cytarabine IV bd 2g/m2 2              
28 days Carboplatin IV 200mg/m2 1-3              
  Hydroxyurea oral qid 750mg/m2 1-3 500mg tabs
  Rituximab IV 375mg/m2 4              
Hi-dICE Ifosfamide IV 5g/m2 2              
R-Hi-dICE MESNA IV 5g/m2 2              
28 days MESNA IV 1g/m2 3              
Carboplatin IV AUC 5 2
  Etoposide IV 100mg/m2 1-3              
  Rituximab IV 375mg/m2 3              
Hi-dICE OP Ifosfamide IV 1.67g/m2 1-3              
R-Hi-dICE OP MESNA iv 400mg/m2 1-3              
28 days MESNA oral @ 4 & 8 hrs 670mg/m2 1-3 400 or 600mg tabs            
Carboplatin IV AUC 5 2
  Etoposide IV 100mg/m2 1-3              
  Rituximab IV 375mg/m2 3              
FC Fludarabine  oral 45mg/m2 1-3 10mg tabs            
FCR Cyclophosphamide oral 250mg/m2 1-3 50mg tabs            
28 days Rituximab IV 375mg/m2 3              
FMD Fludarabine  oral 45mg/m2 1-3              
R-FMD Mitozantrone IV 10mg/m2 1              
28 days Dexamathasone oral 20mg 1-5
  Rituximab IV 375mg/m2 3              
IVE Epirubicin IV 50mg/m2 1              
28 days Ifosfamide cont Infn 3g/m2 1-3              
  MESNA cont infn 3g/m2 1-3              
  MESNA  IV 1g/m2 4              
  Etoposide IV 200mg/m2 1-3              
Gem-Vin Gemcitabine IV 1200mg/m2 1 & 8              
28 days Vinorelbine IV 25mg/m2 1 & 8              
Cladribine Cladribine sc or iv 0.14mg/m2 1-5              
1 cycle                    
Campath Alemutzumab IV 3mg 1
Single course 10mg 3
30mg 5
    30mg 3 x week up to 12 weeks            
HyperCVAD (NHL) Cyclophosphamide IV bd 300mg/m2 1-3 NS 500 over 3hr            
"A" Cycle MESNA cont infn 600mg/m2 1-3              
Methotrexate IT 12mg 2 IntraThecal
Vincristine IVB 2mg  4 & 11
  Doxorubicin IVB 50mg/m2 4              
Dexamethasone oral 40mg 1-4 & 11-14
Cytarabine IT 100mg 8 IntraThecal
  Pegfilgrastim sc 6mg 5
HD MTX-AraC (NHL) Methotrexate IV 200mg/m2 1 over 2h            
"B" Cycle Methotrexate IV 800mg/m2 1 over 22h            
Methotrexate IT 12mg 2 IntraThecal
Leucovorin IV 60mg 2 @ 36hrs (12 hr post MTX)
Leucovorin IV/oral qid 15mg 2 - until MTX level <0.1
  Cytarabine IV bd 2g/m2 2-3              
Cytarabine IT 100mg 8 IntraThecal
  Pegfilgrastim sc 6mh 5              
CODOX-M Cyclophosphamide IV 800mg/m2 1
Vincristine IV 1.4mg/m2 1 & 8 Max 2mg
Doxorubicin IV 40mg/m2 1
Cytarabine IT 70mg 1 & 3 IntraThecal
Cyclophosphamide iv/oral 200mg/m2 2-5
Methotrexate IV 300mg/m2 10 over 1hr
Methotrexate  IV infusion 2700mg/m2 10 over 23 hr
Folinic Acid IV 15mg/m2 11-13+ start @46h after MTX starts; contimue until MTX level <0.1
Pegfilgrastim sc 6mg 13
Methotrexate IT 12mg 15 IntraThecal            
IVAC Etoposide IV 60mg/m2 1-5
Ifosfamide IV 1500mg/m2 1-5
MESNA IV 1500mg/m2 1-5
MESNA IV 300mg/m2 1-5 4hr & 8hr post-Ifos
Cytarabine IV bd 2g/m2 1-2
Methotrexate IT 12mg 5 IntraThecal
Pegfilgrastim sc 6mg 6
  HODGKINS      

TOP

           
ABVD Doxorubicin IVB 25mg/2 1 & 15
28 days Bleomycin IV 10U/m2 1 & 15              
  Vinblastine IV 6mg/m2 1 & 15              
  Dacarbazine IV 375mg/m2 1 & 15              
mini-BEAM Carmustine (BCNU) IV 60mg/m2 1              
  Etoposide IV 75mg/m2 2-5              
  Cytarabine IV bd 100mg/m2 2-5              
  Melphalan IV 30mg/m2 6              
BEACOPP Bleomycin IV 10mg/m2 8              
Baseline Etoposide IV 100mg/m2 1-3              
21 days Doxorubicin IVB 25mg/m2 1              
  Cyclophosphamide IV 650mg/m2 1              
  Vincristine IV 1.4mg/m2 8 Max 2mg            
  Procarbazine oral 100mg/m2 1-7              
  Prednisolone oral 40mg/m2 1-14              
BEACOPP Bleomycin IV 10mg/m2 8              
Escalated Etoposide IV 200mg/m2 1-3              
21 days Doxorubicin IVB 35mg/m2 1              
  Cyclophosphamide IV 1250mg/m2 1              
  Vincristine IV 1.4mg/m2 8 Max 2mg            
  Procarbazine oral 100mg/m2 1-7              
  Prednisolone oral 40mg/m2 1-14              
  MYELOMA      

TOP

           
M & P Melphalan oral 0.25mg/kg 1-5 2mg tabs [10mg max]
28 days Prednisolone oral 2mg/kg 1-5              
VAD Vincristine con infn 0.4mg 1-4
28 days Doxorubicin cont infn 9mg/m2 1-4              
  Dexamethasone oral 40mg 1-4 Cycle 1 Also: D9-12, D17-20            
CTD Cyclophosphamide oral 500mg 1,8,15
21 days Thalidomide 100-200mg ongoing 50mg caps
  Dexamethasone 40mg 1-4,  12-15              
DT-PACE Dexamethasone 40mg 1-4
28 days Thalidomide 400mg ongoing
  Cisplatin 10mg/m2 1-4              
  Cyclophosphamide 400mg/m2 1-4              
  Etoposide 40mg/m2 1-4              
  Doxorubicin 10mg/m2 CI 1-4              
   AUTOGRAFT    

TOP

           
Cyclo Mobilisation MESNA pre-chemo IV 20% cyclo dose 1
  Cyclophosphamide IV 4g/m2 1              
  MESNA post-chemo IV: 20% @ 4 & 8h 1              
oral:40% @ 2 & 6 h
  Filgrastim sc bd 5ug/kg 2 - harvest Harvest ~Day 10            
BEAM Carmustine (BCNU) IV 300mg/m2 -6              
  Etoposide IV 200mg/m2 -5 to -2              
  Cytarabine IV bd 200mg/m2 -5 to -2              
  Melphalan IV 140mg/m2 -1              
  Stem Cells   0 24 hr after chemo            
Melphalan Methlyprednisolone IV

1g

-5 to -1
Melphalan IV 140-200mg/m2 -1
Stem Cells 0 24 hr after chemo
  AML ALL      

TOP

           
Big ICE Idarubicin IV 9mg/m2 1-3              
1 cycle only Cytarabine IV bd 3g/m2 1,3,5,7              
  Etoposide IV 7mg/m2 1-7              
Litle IcE Idarubicin IV 12mg/m2 1-3 9mg/m2 if >60 yrs            
(Induction) Cytarabine cont infn 100mg/m2 1-7              
1 or 2 cycles Etoposide IV 75mg/m2 1-7              
Little IcE Idarubicin IV 12mg/m2 1-3 9mg/m2 if >60 yrs            
(Consolidaton) Cytarabine cont infn 100mg/m2 1-5              
2 cycles Etoposide IV 75mg/m2 1-5              
Ida-FLAG Idarubicin IV 10mg/m2 1-3              
3 cycles usually Fludarabine IV 30mg/m2 1-5 NS 100 30min            
  Cytarabine IV 2g/m2 1-5 NS 250 4h. Start 4h after Fludarabine            
  Filgrastim sc 5mcg/kg 1 - ANC>1.0              
FLICC Mitoxantrone 6mg/m2 1-3 Therapy after 7 days depends            
  Cytarabine bd 10mg/m2 1-7 (14) on degree of pancytopenia            
  Etoposide oral 100mg 1-7 (14)              
APML4 (ALLG) ATRA oral 45mg/m2 1-36              
Induction (Cycle 1) Idarubicin IV 12mg/m2 2,4,6,8              
  As2O3 IV 0.15mg/kg 9-36              
  Prednisolone oral 1mg/kg 1-10 Continue if WCC>1 or ATRA syndrome            
Consolidation 1 (C2) ATRA oral 45mg/m2 1-28              
  As2O3 IV 0.15mg/kg 1-28              
Consolidation 2 (C3) ATRA oral 45mg/m2 1-7  15-21,  29-35            
  As2O3 IV 0.15mg/kg 1-5  8-12  15-19  22-26 29-33            
Maintenance ATRA oral 45mg/m2 1-14              
3 month cycles x8 Mercaptopurine oral 50-90mg/m2 15-90              
  Methotrexate oral 5-15mg/m2 weekly from wk 2            
HyperCVAD (ALL) Cyclophosphamide IV bd 300mg/m2 1-3 NS 500 over 3hr            
"A" Cycle MESNA cont infn 600mg/m2 1-3              
Methotrexate IT 12mg 2 IntraThecal
Vincristine IVB 2mg  4 & 11
  Doxorubicin IVB 50mg/m2 4              
Dexamethasone oral 40mg 1-4 & 11-14
Cytarabine IT 100mg 8 IntraThecal
  Pegfilgrastim sc 6mg 5
HD MTX-AraC (ALL) Methotrexate IV 200mg/m2 1 over 2h