Difference between revisions of "HIV-associated lymphoma"
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| + | =R-CODOX-M/IVAC= | ||
| + | ==Regimen== | ||
| + | To be completed | ||
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| + | ==References== | ||
| + | # Kassam S, Bower M, Lee SM, de Vos J, Fields P, Gandhi S, Nelson M, Montoto S, Tenant-Flowers M, Burns F, Marcus R, Edwards SG, Cwynarski K. A retrospective, multi-center analysis of treatment intensification for HIV-positive patients with high-risk diffuse large B-cell lymphoma. Leuk Lymphoma. 2012 Dec 3. [Epub ahead of print] [http://informahealthcare.com/doi/abs/10.3109/10428194.2012.754024 link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/23206228 PubMed] | ||
=R-EPOCH, dose-escalated (EPOCH-R)= | =R-EPOCH, dose-escalated (EPOCH-R)= | ||
Revision as of 03:40, 18 December 2012
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
R-CODOX-M/IVAC
Regimen
To be completed
References
- Kassam S, Bower M, Lee SM, de Vos J, Fields P, Gandhi S, Nelson M, Montoto S, Tenant-Flowers M, Burns F, Marcus R, Edwards SG, Cwynarski K. A retrospective, multi-center analysis of treatment intensification for HIV-positive patients with high-risk diffuse large B-cell lymphoma. Leuk Lymphoma. 2012 Dec 3. [Epub ahead of print] link to original article PubMed
R-EPOCH, dose-escalated (EPOCH-R)
Regimen
- Rituximab (Rituxan) 375 mg/m2 IV "before each EPOCH cycle"
- Etoposide (Vepesid) 50 mg/m2/day (total dose of 200 mg/m2) IV continuous infusion on days 1-4
- Prednisone (Sterapred) 60 mg/m2 PO BID on days 1-5
- Vincristine (Oncovin) 0.4 mg/m2/day (total dose of 1.6 mg/m2) IV continuous infusion on days 1-4
- Doxorubicin (Adriamycin) 10 mg/m2/day (total dose of 40 mg/m2) IV continuous infusion on days 1-4
- Cyclophosphamide (Cytoxan) 187 mg/m2 (if CD4 count <100/uL) or 375 mg/m2 (if CD4 count >100/uL) IV over 15 minutes on day 5
- In each subsequent cycle, increase dose of Cyclophosphamide (Cytoxan) by 187 mg/m2 if the neutrophil nadir is >500/μL and platelet nadir is >25/μL. Decrease dose of Cyclophosphamide (Cytoxan) by 187 mg/m2 if the neutrophil nadir is <500/μL or platelet nadir is <25/μL.
21-day cycles x 6-8 cycles
Supportive medications:
- EITHER Filgrastim (Neupogen) 5 mcg/kg SC daily, starting 24 hours after EPOCH is completed and continuing until "neutrophil recovery"—no absolute count specified
- OR Pegfilgrastim (Neulasta) 6 mg SC x1 24 hours after EPOCH is completed
- Trimethoprim/Sulfamethoxazole (Bactrim DS) 160/800 mg PO 3x per week (e.g. Monday, Wednesday, Friday)
- Fluconazole (Diflucan) 100 mg PO daily
- Ciprofloxacin (Cipro) 500 mg PO BID, starting on day 8 and to continue to at least day 15 or postnadir ANC of at least 1000
- Other fluoroquinolone can be used at discretion of physician
References
- Sparano JA, Lee JY, Kaplan LD, Levine AM, Ramos JC, Ambinder RF, Wachsman W, Aboulafia D, Noy A, Henry DH, Von Roenn J, Dezube BJ, Remick SC, Shah MH, Leichman L, Ratner L, Cesarman E, Chadburn A, Mitsuyasu R; AIDS Malignancy Consortium. Rituximab plus concurrent infusional EPOCH chemotherapy is highly effective in HIV-associated B-cell non-Hodgkin lymphoma. Blood. 2010 Apr 15;115(15):3008-16. Epub 2009 Dec 18. link to original article contains verified protocol PubMed