Difference between revisions of "Classical Hodgkin lymphoma"
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==ABVD ([[Doxorubicin (Adriamycin)]], [[Bleomycin (Blenoxane)]], [[Vinblastine (Velban)]], [[Dacarbazine (DTIC)]] (stage I-IV Hodgkin lymphoma)== | ==ABVD ([[Doxorubicin (Adriamycin)]], [[Bleomycin (Blenoxane)]], [[Vinblastine (Velban)]], [[Dacarbazine (DTIC)]] (stage I-IV Hodgkin lymphoma)== | ||
| − | *Doxorubicin (Adriamycin) 25 mg/m2 IV | + | ===Regimen=== |
| − | *Bleomycin (Blenoxane) 10 units/m2 IV | + | *Doxorubicin (Adriamycin) 25 mg/m2 IV days 1 & 15 |
| − | *Vinblastine (Velban) 6 mg/m2 IV | + | *Bleomycin (Blenoxane) 10 units/m2 IV days 1 & 15 (1 unit test dose with cycle 1 doses, 60 minutes prior to remainder of full dose) |
| − | *Dacarbazine (DTIC) 375 mg/m2 | + | *Vinblastine (Velban) 6 mg/m2 IV days 1 & 15 |
| + | *Dacarbazine (DTIC) 375 mg/m2 IV days 1 & 15 | ||
Q28days x 4-6 cycles based on stage, response, and concurrent therapy. | Q28days x 4-6 cycles based on stage, response, and concurrent therapy. | ||
| Line 10: | Line 11: | ||
[[Antiemesis|Antiemetic risk]]: high | [[Antiemesis|Antiemetic risk]]: high | ||
*Acetaminophen 650 mg PO, 30 minutes prior to chemotherapy. | *Acetaminophen 650 mg PO, 30 minutes prior to chemotherapy. | ||
| − | *Aprepitant (Emend) 125 mg PO on | + | *Aprepitant (Emend) 125 mg PO on days 1 & 15 prior to chemotherapy, 80mg PO on days 2-3, 16-17 |
| − | *Ondansetron (Zofran) 8 mg PO, 30 minutes prior to chemotherapy on | + | *Ondansetron (Zofran) 8 mg PO, 30 minutes prior to chemotherapy on days 1 & 15, daily on days 2-3, 16-17 |
| − | *Dexamethasone 4 mg PO BID on | + | *Dexamethasone 4 mg PO BID on days 1-3, days 15-17 |
| − | *Diphendyramine (Benadryl) 25 mg PO on | + | *Diphendyramine (Benadryl) 25 mg PO on day 1 & 15 prior to chemotherapy |
===Supportive Hydration=== | ===Supportive Hydration=== | ||
Revision as of 02:00, 14 November 2011
ABVD (Doxorubicin (Adriamycin), Bleomycin (Blenoxane), Vinblastine (Velban), Dacarbazine (DTIC) (stage I-IV Hodgkin lymphoma)
Regimen
- Doxorubicin (Adriamycin) 25 mg/m2 IV days 1 & 15
- Bleomycin (Blenoxane) 10 units/m2 IV days 1 & 15 (1 unit test dose with cycle 1 doses, 60 minutes prior to remainder of full dose)
- Vinblastine (Velban) 6 mg/m2 IV days 1 & 15
- Dacarbazine (DTIC) 375 mg/m2 IV days 1 & 15
Q28days x 4-6 cycles based on stage, response, and concurrent therapy.
Supportive medications
Antiemetic risk: high
- Acetaminophen 650 mg PO, 30 minutes prior to chemotherapy.
- Aprepitant (Emend) 125 mg PO on days 1 & 15 prior to chemotherapy, 80mg PO on days 2-3, 16-17
- Ondansetron (Zofran) 8 mg PO, 30 minutes prior to chemotherapy on days 1 & 15, daily on days 2-3, 16-17
- Dexamethasone 4 mg PO BID on days 1-3, days 15-17
- Diphendyramine (Benadryl) 25 mg PO on day 1 & 15 prior to chemotherapy
Supportive Hydration
- 500 ml NS at KVO rate. Use as running IV for chemotherapy infusion.
Pretreatment monitoring parameters
- CBC with diff, liver function tests, pulmonary function tests with DLCO
References
- Canellos GP, et al. Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med. 1992 Nov 19;327(21):1478-84.PubMed
- Gianni AM et al. Comparable 3-year outcome following ABVD or BEACOPP first-line chemotherapy, plus pre-planned high-dose salvage, in advanced Hodgkin's lymphoma (HL): a randomized trial of the Michelangelo, GITIL and IIL cooperative groups. 2008 ASCO annual meeting. Abstract 8506
- Bonadonna G et al. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin's disease: long-term results. J Clin Oncol 2004; 22:2835
- Carde, P et al. Clinical staging versus laparotomy and combined modality with MOPP versus ABVD in early-stage Hodgkin's disease: The H6 twin randomized trials from the European Organization for Research and Treatment of Cancer Lymphoma Cooperative Group. J Clin Oncol 1993; 11:2258
- Canellos GP et al. Chemotherapy of advanced Hodgkin’s disease with MOPP, ABVD, or MOPP alternating with ABVD. N Eng J Med 1992; 327:1478
- Engert A et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: Final results of the GHSG HD7 trial. J Clin Oncol 2007; 25:3495