Chemotherapy Protocol

  DISEASE: Acute Lymphocytic

REGIMEN: CALG-B(LARSON)(INDUCTION)

CYCLOPHOSPHAMIDE [CTX] 1200 mg/m2 IV...D1

DAUNORUBICIN [DNR] 45 mg/m2 per day IV...D1-3
Caution: Monitor cumulative dose (cardiac toxicity)

VINCRISTINE [VCR] 2 mg IV...D1,8,15,22
Maximum dose is 2 mg

PREDNISONE [Pred] 60 mg/m2 per day PO...D1-21

L-ASPARAGINASE [A-ase] 6000 units/m2 IV...D5,8,11,15,18,22

CYCLE: None
REFER: Larson RA, et al: PROC ASCO 1992; 11:263.


DISEASE: Chronic Lymphocytic

REGIMEN: CP

CHLORAMBUCIL [Chl] .4 mg/kg PO...D1
q other wk

PREDNISONE [Pred] 100 mg per day PO...D1-7
q other wk

CYCLE: None
REFER: Leukeran (R) (chlorambucil) Tablets, Burroughs Wellcome Co., full prescribing info, PHYSICIANS DESK REFERENCE 49th Ed. Montvale,NJ; 1995;781.


DISEASE: Chronic Lymphocytic

REGIMEN: CVP-2

CYCLOPHOSPHAMIDE [CTX] 400 mg/m2 per day PO...D1-5

VINCRISTINE [VCR] 2 mg/m2 IV...D1
Maximum dose is 2 mg

PREDNISONE [Pred] 100 mg/m2 per day PO...D1-5

CYCLE: 21 - 28 days
REFER: Skeel RT: Handbook of Cancer Chemotherapy, 3rd Ed. Little, Brown & Co. 1991; 319.


DISEASE: Chronic Lymphocytic

REGIMEN: FAMP

FLUDARABINE [FLUD] 25 - 30 mg/m2 per day IV/30 min...D1-5
Over 30 minutes

CYCLE: 4 wks
REFER: Skeel RT: Handbook of Cancer Chemotherapy, 3rd Ed. Little, Brown & Co. 1991; 110.

DISEASE: Acute Myelogenous

REGIMEN: A+D(7+3)(INDUCTION)

CYTARABINE [ARA-C] 100 mg/m2 per day x 7 CIV...D1-7

DAUNORUBICIN [DNR] 45 mg/m2 per day IV...D1-3
Caution: Monitor cumulative dose (cardiac toxicity) Note: Repeat for further induction or consolidation with cytarabine x 5 days and daunorubicin x 2 days

CYCLE: None
REFER: Dillman RO, et al: BLOOD 1991; 78:2520-2526.


DISEASE: Acute Myelogenous

REGIMEN: A+D+E(7+3+7)(INDUCTION)

CYTARABINE [ARA-C] 100 mg/m2 per day CIV...D1-7

DAUNORUBICIN [DNR] 50 mg/m2 per day IV...D1-3
Caution: Monitor cumulative dose (cardiac toxicity)

ETOPOSIDE [VP-16] 75 mg/m2 per day IV/1 hr...D1-7

CYCLE: Induction
REFER: Bishop J, et al: BLOOD 1990; 1/1 75(1):27-32.


DISEASE: Acute Myelogenous

REGIMEN: HiDAC

CYTARABINE [ARA-C] 1.5 - 3 g/m2 IV/12 h
x 4-6 days

CYCLE: None
REFER: Bloomfield CD, Herzig GP, eds.: HEMATOLOGY/ONCOLOGY CLINICS OF NORTH AMERICA 1993; 7:47-79.


DISEASE: Acute Myelogenous

REGIMEN: IDA-AR 1 (INDUCTION)

IDARUBICIN [IDA] 12 mg/m2 per day IV...D1-3
Caution: Monitor cumulative dose (cardiac toxicity)

CYTARABINE [ARA-C] 100 mg/m2 per day x 7 CIV...D1-7

CYCLE: None
REFER: Vogler WR, et al: J CLIN ONCOL 1992; 10:1103-1111.


DISEASE: Acute Myelogenous

REGIMEN: IDA-AR 2 (CONSOLIDATION)

THIOGUANINE [6-TG] 100 mg/m2 PO q 12h
x 10 doses

CYTARABINE [ARA-C] 100 mg/m2 IV q 12h
x 10 doses

IDARUBICIN [IDA] 15 mg/m2 IV...D1
Caution: Monitor cumulative dose (cardiac toxicity)

CYCLE: 21-28 days x 3 courses
REFER: Vogler WR, et al: J CLIN ONCOL 1992; 10:1103-1111.


DISEASE: Acute Myelogenous

REGIMEN: MC (INDUCTION)

MITOXANTRONE [DHAD] 12 mg/m2 per day IV...D1-3
Caution: Monitor cumulative dose (cardiac toxicity)

CYTARABINE [ARA-C] 100 mg/m2 per day x 7 CIV...D1-7

CYCLE: Induction
REFER: Arlin Z, et al: LEUKEMIA 1990; 4:177-183.

DISEASE: Chronic Myelogenous

REGIMEN: BUSULFAN

BUSULFAN [BU] 4 - 8 mg PO q d

CYCLE: None
REFER: Myleran (R) (busulfan) Burroughs Wellcome Co, full prescribing info in PHYSICIANS DESK REFERENCE 49th Ed. Montvale,NJ; 1995;781.


DISEASE: Chronic Myelogenous

REGIMEN: HYDROXYUREA

HYDROXYUREA [HU] .5 - 1.5 g/m2 PO/d

CYCLE: None
REFER: Skeel RT: Handbook of Cancer Chemotherapy, 3rd Ed. Little, Brown & Co. 1991; 313.


DISEASE: Chronic Myelogenous

REGIMEN: IFN-a

IFN-alpha [IFN-a] 5 MU/m2 per day IM

CYCLE: None
REFER: Talpaz M, et al: NEJM 1986; 314:1065-1069.

DISEASE: Lymphona: Hodgkins

REGIMEN: ABVD

DOXORUBICIN [DOX] 25 mg/m2 IV...D1,14
Caution: Monitor cumulative dose (cardiac toxicity)

BLEOMYCIN [BLEO] 10 units/m2 IV...D1,14
Caution: Monitor cumulative dose (pulmonary toxicity)

VINBLASTINE [VLB] 6 mg/m2 IV...D1,14

DACARBAZINE [DTIC] 150 mg/m2 IV... D1-5

CYCLE: 28 days for 6 cycles
REFER: Bonadonna G, et al: CANCER 1975; 36:252-259.


DISEASE: Lymphoma: Hodgkin's

REGIMEN: BCVPP

CARMUSTINE [BCNU] 100 mg/m2 IV... D1
Caution: Monitor cumulative dose (pulmonary and marrow toxicity)

VINBLASTINE [VLB] 5 mg/m2 IV... D1

CYCLOPHOSPHAMIDE [CTX] 600 mg/m2 IV... D1

PROCARBAZINE [PCB] 50 mg/m2 PO... D1
1st day only

PROCARBAZINE [PCB] 100 mg/m2 per day PO... D2-10
After 1st day

PREDNISONE[Pred] 60 mg/m2 per day PO... D1-10

CYCLE: 28 days
REFER: Bakemeier RF, et al: ANN INTERN MED 1984; 101:447-456.


DISEASE: Lymphoma: Hodgkin's

REGIMEN: EVA

ETOPOSIDE [VP-16] 100 mg/m2 per day IV... D1-3

VINBLASTINE [VLB] 6 mg/m2 IV... D1

DOXORUBICIN [DOX] 50 mg/m2 IV... D1
Caution: Monitor cumulative dose (cardiac toxicity)

CYCLE: 28 days for 6 cycles
REFER: Canellos GP, et al: PROC ASCO 1991; 10:273.


DISEASE: Lymphoma: Hodgkin's

REGIMEN: MOPP

MECHLORETHAMINE [HN(2)] 6 mg/m2 IV... D1,8

VINCRISTINE [VCR] 1.4 mg/m2 IV... D1,8
(No cap at 2 mg)

PROCARBAZINE [PCB] 100 mg/m2 per day PO... D1-14

PREDNISONE [Pred] 40 mg/m2 per day PO... D1-14

CYCLE: 28 days
REFER: DeVita VT, et al: PPO UPDATES 1993; 7:1-11.


DISEASE: Lymphoma: Hodgkin's

REGIMEN: MOPP/ABV

MECHLORETHAMINE [HN(2)] 6 mg/m2 IV... D1

VINCRISTINE [VCR] 1.4 mg/m2 IV... D1

PROCARBAZINE [PCB] 100 mg/m2 per day PO... D1-7

PREDNISONE [Pred] 40 mg/m2 per day PO... D1-14

DOXORUBICIN [DOX] 35 mg/m2 IV... D8
Caution: Monitor cumulative dose (cardiac toxicity)

BLEOMYCIN [BLEO] 10 units/m2 IV... D8
Caution: Monitor cumulative dose (pulmonary toxicity)

VINBLASTINE [VLB] 6 mg/m2 IV... D8

CYCLE: 28 days
REFER: Connors JM, et al: PROC ASCO 1992; 11:317.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: CHOP

CYCLOPHOSPHAMIDE [CTX] 750 mg/m2 IV... D1

DOXORUBICIN [DOX] 50 mg/m2 IV... D1
Caution: Monitor cumulative dose (cardiac toxicity)

VINCRISTINE [VCR] 1.4 mg/m2 IV... D1
Maximum dose is 2 mg

PREDNISONE [Pred] 100 mg per day PO... D1-5

CYCLE: 21 days
REFER: Skeel RT: Handbook of Cancer Chemotherapy, 3rd Ed. Little, Brown & Co. 1991; 343.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: CHOP-BLEO

CYCLOPHOSPHAMIDE [CTX] 750 mg/m2 IV... D1

DOXORUBICIN [DOX] 50 mg/m2 IV... D1
Caution: Monitor cumulative dose (cardiac toxicity)

VINCRISTINE [VCR] 2 mg IV... D1,5
Maximum dose is 2 mg

PREDNISONE [Pred] 100 mg per day PO... D1-5

BLEOMYCIN [BLEO] 15 units per day IV... D1-5
Caution: Monitor cumulative dose (pulmonary toxicity)

CYCLE: 14 or 21 days
REFER: Rodriguez V, et al: BLOOD 1977; 49:325-333.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: COMLA

CYCLOPHOSPHAMIDE [CTX] 1500 mg/m2 IV... D1

VINCRISTINE [VCR] 1.4 mg/m2 IV... D1,8,15
Maximum dose is 2 mg

METHOTREXATE [MTX] 120 mg/m2 IV... D22,29,36,43,50,57,64,71

LEUCOVORIN [Leu] 25 mg/m2 PO... D23,30,37,44,51,58,65,72
q6h x 4 doses beginning 24 hr post MTX

CYTARABINE [ARA-C] 300 mg/m2 IV... D22,29,36,43,50,57,64,71

CYCLE: 91 days
REFER: Gaynor ER, et al: J CLIN ONCOL 1985; 3:1596-1604.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: COP

CYCLOPHOSPHAMIDE [CTX] 400 - 800 mg/m2 IV... D1

VINCRISTINE [VCR] 2 mg IV... D1
Maximum dose is 2 mg

PREDNISONE [Pred] 60 mg/m2 per day PO... D1-5
Followed by tapering dose 40,20,10 mg/day

CYCLE: 14 days
REFER: Luce JK, et al: CANCER 1971; 28:306-317.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: CVP-1

CYCLOPHOSPHAMIDE [CTX] 400 mg/m2 per day PO... D1-5

VINCRISTINE [VCR] 1.4 mg/m2 IV... D1
Maximum dose is 2 mg

PREDNISONE [Pred] 100 mg/m2 per day PO... D1-5

CYCLE: 21 days
REFER: Bagley CM, et al: ANN INTERN MED 1972; 76:227-234.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: DHAP

CISPLATIN [CDDP] 100 mg/m2 CIV over 24 hrs... D1

CYTARABINE [ARA-C] 2 g/m2 IV over 3 hrs... D2
After Cisplatin repeat dose 12 hrs later for total dose of 4 g/m2

DEXAMETHASONE [DEX] 40 mg per day PO or IV... D1-4
For 4 days

CYCLE: 3-4 weeks
REFER: Velasquez WS, et al: BLOOD 1988; 71:117-122.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: ESAP

METHYLPREDNISOLONE[SOL] 500 mg per day IV... D1-4

ETOPOSIDE [VP-16] 40 mg/m2 per day IV... D1-4

CYTARABINE [ARA-C] 2 g/m2 IV... D5
Over 2 hr, after completion of Cisplatin

CISPLATIN [CDDP] 25 mg/m2 per day x 4 CIV... D1-4
(Total Dose 100 mg)

CYCLE: As tolerated
REFER: Velasquez W, et al: PROC ASCO 1989; 8:256.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: MACOP-B

METHOTREXATE [MTX] 400 mg/m2 IV... weeks 2,6,10

LEUCOVORIN [Leu] 15 mg PO
q 6 hr x 6 doses, starting 24hr after MTX

DOXORUBICIN [DOX] 50 mg/m2 IV... weeks 1,3,5,7,9,11
Caution: Monitor cumulative dose (cardiac toxicity)

CYCLOPHOSPHAMIDE [CTX] 350 mg/m2 IV... weeks 1,3,5,7,9,11

VINCRISTINE [VCR] 1.4 mg/m2 IV... weeks 2,4,6,8,10,12
Max dose 2mg

BLEOMYCIN [BLEO] 10 units/m2 IV... weeks 4,8,12
Caution: Monitor cumulative dose (pulmonary toxicity)

PREDNISONE [Pred] 75 mg per day PO
Tapered over last 15 days

CYCLE: None
REFER: Connors JM, et al (eds). Update on Treatment for Diffuse Large Cell Lymphoma. Wiley & Sons 1986; 37-43.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: MIV

MITOXANTRONE [DHAD] 10 mg/m2 IV... D1
Caution: Monitor cumulative dose (cardiac toxicity)

IFOSFAMIDE [IFF] 1500 mg/m2 per day IV... D1-3
With MESNA

ETOPOSIDE [VP-16] 150 mg/m2 per day IV... D1-3

CYCLE: 21 days
REFER: Herbrecht R, et al: PROC ASCO 1991; 10:278.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: m-BACOD

METHOTREXATE [MTX] 200 mg/m2 IV... D8,15

LEUCOVORIN [Leu] 10 mg/m2 PO... D9,16
q6h x 8 doses starting 24h after MTX

BLEOMYCIN [BLEO] 4 units/m2 IV... D1
Caution: Monitor cumulative dose (pulmonary toxicity)

DOXORUBICIN [DOX] 45 mg/m2 IV... D1
Caution: Monitor cumulative dose (cardiac toxicity)

CYCLOPHOSPHAMIDE [CTX] 600 mg/m2 IV... D1

VINCRISTINE [VCR] 1 mg/m2 IV... D1
Maximum dose is 2 mg

DEXAMETHASONE [DEX] 6 mg/m2 per day PO... D1-5

CYCLE: 3 Wks.
REFER: Shipp MA, et al: ANN INTERN MED 1986; 104:757-765.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: PROMACE-CYTABOM

PREDNISONE [Pred] 60 mg/m2 per day PO... D1-14

DOXORUBICIN [DOX] 25 mg/m2 IV... D1
Caution: Monitor cumulative dose (cardiac toxicity)

CYCLOPHOSPHAMIDE [CTX] 650 mg/m2 IV... D1

ETOPOSIDE [VP-16] 120 mg/m2 IV... D1

CYTARABINE [ARA-C] 300 mg/m2 IV... D8

BLEOMYCIN [BLEO] 5 units/m2 IV... D8
Caution: Monitor cumulative dose (pulmonary toxicity)

VINCRISTINE [VCR] 1.4 mg/m2 IV... D8
Maximum dose is 2 mg

METHOTREXATE [MTX] 120 mg/m2 IV... D8

LEUCOVORIN [Leu] 25 mg PO... D9
q6h x 4 doses starting 24 hrs after MTX

CYCLE: 21 days, next cycle begins on D22
REFER: Fisher RI, et al: PROC ASCO 1984; 242. Abstract.


DISEASE: Lymphoma: Non Hodgkin's

REGIMEN: VACOP-B

ETOPOSIDE [VP-16] 50 mg/m2 IV... D1
And 100 mg/m2 per day PO D2,3 of week 3,7,11

DOXORUBICIN [DOX] 50 mg/m2 IV... weeks 1,3,5,7,9,11
Caution: Monitor cumulative dose (cardiac toxicity)

CYCLOPHOSPHAMIDE [CTX] 350 mg/m2 IV... weeks 1,5,9

VINCRISTINE [VCR] 1.2 mg/m2 IV... weeks 2,4,6,8,10,12
No maximum vincristine dose

PREDNISONE [Pred] 45 mg/m2 PO... q Dx1 week, then q OD x 11 wks

BLEOMYCIN [BLEO] 10 units/m2 IV... weeks 2,4,6,8,10,12
Caution: Monitor cumulative dose (pulmonary toxicity)

CYCLE: None
REFER: Connors JM, et al: PROC ASCO 1990; 9:254.


DISEASE: Multiple Myeloma

REGIMEN: DEXA

DEXAMETHASONE [DEX] 40 mg per day PO... D1-4,9-12,17-20

CYCLE: 36 days
REFER: Alexanian R: ANN INTERN MED 1986; 105:8-11.


DISEASE: Multiple Myeloma

REGIMEN: MP1

MELPHALAN [L-Pam] .15 mg/kg per day PO... D1-7

PREDNISONE [Pred] 20 mg TID PO... D1-7

CYCLE: 6 weeks
REFER: Kyle RA, Greipp PA: CRC CRIT REV ONCOL/HEMATOL 1988; 8:93-152.


DISEASE: Multiple Myeloma

REGIMEN: MP 2

MELPHALAN [L-Pam] .25 mg/kg per day PO... D1-4

PREDNISONE [Pred] 2 mg/kg per day PO... D1-4

CYCLE: 6 weeks
REFER: Alkeran (R) (melphalan) Tablets, Burroughs Wellcome Co, full prescribing info in PHYSICIANS DESK REFERENCE 49th Ed. Montvale,NJ; 1995;746.


DISEASE: Multiple Myeloma

REGIMEN: MP 3

MELPHALAN [L-Pam] 16 mg/m2 per day IV
Every 2 weeks for 4 doses, then every 4 weeks

PREDNISONE [Pred] .8 mg/kg per day PO... D1-14
Maximum dose is 100 mg/day

PREDNISONE [Pred] .4 mg/kg per day PO... D15-28
Maximum dose is 100 mg/day

PREDNISONE [Pred] .2 mg/kg per day PO... D29-42
Maximum dose is 100 mg/day

CYCLE: None
REFER: Cooper MR, et al: J CLIN ONCOL 1986; 4(9):1331 - 1339.


DISEASE: Multiple Myeloma

REGIMEN: VAD

VINCRISTINE [VCR] .4 mg per day x 4 CIV... D1-4
Maximum dose is 2 mg

DOXORUBICIN [DOX] 9 mg/m2 per day x 4 CIV... D1-4
Caution: Monitor cumulative dose (cardiac toxicity)

DEXAMETHASONE [DEX] 40 mg per day PO... D1-4,9-12,17-20

CYCLE: 28 days
REFER: Barlogie B, et al: NEJM 1984; 310:1353-1356.


Body Surface Area (in meters squared )

BSA = 0.007184 x [Weight in kg] to power 0.425 x [Height in cm] to power 0.725

(Dubois, Arch Intern Med 1916; 17:863-871)

Ideal Body Weight [in kg]

For Males
IBW = 51.65 + 1.85 x ([Height in inches] - 60)

For Females
IBW = 48.67 + 1.65 x ([Height in inches] - 60)

(Am J Hosp Pharm 1983; 40(6):1016-1019)

Basic Energy Expenditure [in KCal/day]

For Males
BEE = 66 + 13.7 x [Weight in kg] + 5.0 x [Height in cm] - 6.8 x Age

For Females
BEE = 655 + 9.6 x [Weight in kg] + 1.8 x [Height in cm] - 4.7 x Age

(Wilson JD, et al: Harrison's Principles of Internal Medicine, 12th Ed. McGraw-Hill 1991; 430)

Absolute Neutrophil Count [in K/mm3]

ANC = [WBC in K/mm3] x ( [PMN in %] + [Bands in %] ) / 100

Estimated Creatinine Clearance [in cc/min]

For Males
CCr = [Weight in kg] x ( 140 - Age ) / (72 x SerumCreatinine)

For Females
CCr = [Male Est CCr] x 0.85
Serum Creatinine measured in mg/dL

(Cockroft DW, Gault MH: NEPHRON 1976; 16:31-41)

Measured Creatinine Clearance (in cc/min]

CCr = (UrineCreatinine x UrineVolume)/(1440 x SerumCreatinine)

Serum Creatinine measured in mg/dL
Urine Creatinine measured in mg/dL
Urine Volume measured in mL/24 hrs

(Comstock,TJ. Pharmaco Therapy; Elsevier 1992:645-659)