Latest revision as of 21:53, 20 December 2023

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-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 [[How_to_contribute|invited to contribute to the site]].
+<big>'''This is an obsolete page; please follow the links below to find the page you're looking for.'''</big>
-{{TOC limit|limit=3}}
-=Autologous (auto) stem cell transplant=
+=[[Stem cell mobilization]]=
-==BEAC==
-BEAC: '''<u>B</u>'''iCNU, '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C, '''<u>C</u>'''yclophosphamide
-===Regimen ===
-''Autologous blood stem cells are infused on day 0.''
-*[[Carmustine (BiCNU)]] 300 mg/m2 IV on day -7
-*[[Etoposide (Vepesid)]] 800 mg/m2 IV on days -6 to -3
-*[[Cytarabine (Cytosar)]] 800 mg/m2 IV on days -6 to -3
-*[[Cyclophosphamide (Cytoxan)]] 35 mg/kg IV on days -6 to -3
-Supportive medications:
+=[[Autologous_HSCT|Autologous stem cell transplant]]=
-*[[Filgrastim (Neupogen)]] 5 mcg/kg SC daily starting on day +1, continued until there are 3 consecutive days with ANC ≥1000
-*Prophylaxis against opportunistic infections and management of febrile neutropenia per "active protocols"
-===References===
+=[[Allogeneic_HSCT|Allogeneic hematopoietic cell transplant, myeloablative]]=
-# Jo JC, Kang BW, Jang G, Sym SJ, Lee SS, Koo JE, Kim JW, Kim S, Huh J, Suh C. BEAC or BEAM high-dose chemotherapy followed by autologous stem cell transplantation in non-Hodgkin's lymphoma patients: comparative analysis of efficacy and toxicity. Ann Hematol. 2008 Jan;87(1):43-8. Epub 2007 Aug 21. [http://www.springerlink.com/content/r764139714772803/ link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/17710401 PubMed]
-==BEAM==
+=[[Allogeneic_HSCT|Allogeneic hematopoietic cell transplant, reduced-intensity conditioning (RIC)]]=
-BEAM: '''<u>B</u>'''iCNU, '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C, '''<u>M</u>'''elphalan
-===Regimen #1, Jo, et al. 2008===
-''Autologous blood stem cells are infused on day 0.''
-*[[Carmustine (BiCNU)]] 300 mg/m2 IV on day -6
-*[[Etoposide (Vepesid)]] 200 mg/m2 IV on days -5 to -2
-*[[Cytarabine (Cytosar)]] 400 mg/m2 IV on days -5 to -2
-*[[Melphalan (Alkeran)]] 140 mg/m2 IV on day -1
-Supportive medications:
+[[Category:Obsolete pages]]
-*[[Filgrastim (Neupogen)]] 5 mcg/kg SC daily starting on day +1, continued until there are 3 consecutive days with ANC ≥1000
-*Prophylaxis against opportunistic infections and management of febrile neutropenia per "active protocols"
-===Regimen #2, Stewart, et al. 2006===
-''Autologous blood stem cells are infused on day 0.''
-*[[Carmustine (BiCNU)]] 300 mg/m2 IV on day -6
-*[[Etoposide (Vepesid)]] 100 mg/m2 IV Q12H on days -5 to -2 (8 total doses)
-*[[Cytarabine (Cytosar)]] 200 mg/m2 IV Q12H on days -5 to -2 (8 total doses)
-*[[Melphalan (Alkeran)]] 140 mg/m2 IV on day -1
-Supportive medications:
-*Patients <70 kg: [[Filgrastim (Neupogen)]] 300 mcg SC daily starting on day +7 after stem cell transplant
-*Patients >70 kg (reference did not clarify which dosage to use for patients who are exactly 70 kg): [[Filgrastim (Neupogen)]] 480 mcg SC daily starting on day +7 after stem cell transplant
-*Trimethoprim/Sulfamethoxazole (Bactrim DS) (160/800 mg) PO BID on Monday and Thursdays, until 6 months after BEAM
-''While ANC <500''
-*Ciprofloxacin (Cipro) 500 mg PO BID
-*Fluconazole (Diflucan) 100 mg PO daily or mycostatin 500,000 units swish & swallow QID
-*[[Acyclovir (Zovirax)]] 400 mg PO TID
-===Regimen #3, Josting, et al. 2005===
-''Paper did not specify which day peripheral blood stem cells were administered.''
-*[[Carmustine (BiCNU)]] 300 mg/m2 IV on day 1
-*[[Etoposide (Vepesid)]] 150 mg/m2 IV Q12H on days 2-5 (8 total doses)
-*[[Cytarabine (Cytosar)]] 200 mg/m2 IV Q12H on days 2-5 (8 total doses)
-*[[Melphalan (Alkeran)]] 140 mg/m2 IV on day 1
-===Regimen #4, Gisselbrecht, et al. 2010===
-''Autologous blood stem cells are infused on day 0, at least 24 hours after completion of BEAM.''
-*[[Carmustine (BiCNU)]] 300 mg/m2 IV on day -6
-*[[Etoposide (Vepesid)]] 200 mg/m2 IV on days -5 to -2
-*[[Cytarabine (Cytosar)]] 200 mg/m2 IV on days -5 to -2
-*[[Melphalan (Alkeran)]] 140 mg/m2 IV on day -1
-===References===
-# Josting A, Sieniawski M, Glossmann JP, Staak O, Nogova L, Peters N, Mapara M, Dörken B, Ko Y, Metzner B, Kisro J, Diehl V, Engert A. High-dose sequential chemotherapy followed by autologous stem cell transplantation in relapsed and refractory aggressive non-Hodgkin's lymphoma: results of a multicenter phase II study. Ann Oncol. 2005 Aug;16(8):1359-65. Epub 2005 Jun 6. [http://annonc.oxfordjournals.org/content/16/8/1359.long link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/15939712 PubMed]
-# Stewart DA, Bahlis N, Valentine K, Balogh A, Savoie L, Morris DG, Jones A, Brown C, Russell JA. Upfront double high-dose chemotherapy with DICEP followed by BEAM and autologous stem cell transplantation for poor-prognosis aggressive non-Hodgkin lymphoma. Blood. 2006 Jun 15;107(12):4623-7. Epub 2006 Feb 7. [http://bloodjournal.hematologylibrary.org/content/107/12/4623.long link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16467197 PubMed]
-# Jo JC, Kang BW, Jang G, Sym SJ, Lee SS, Koo JE, Kim JW, Kim S, Huh J, Suh C. BEAC or BEAM high-dose chemotherapy followed by autologous stem cell transplantation in non-Hodgkin's lymphoma patients: comparative analysis of efficacy and toxicity. Ann Hematol. 2008 Jan;87(1):43-8. Epub 2007 Aug 21. [http://www.springerlink.com/content/r764139714772803/ link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/17710401 PubMed]
-# Gisselbrecht C, Glass B, Mounier N, Singh Gill D, Linch DC, Trneny M, Bosly A, Ketterer N, Shpilberg O, Hagberg H, Ma D, Brière J, Moskowitz CH, Schmitz N. Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era. J Clin Oncol. 2010 Sep 20;28(27):4184-90. doi: 10.1200/JCO.2010.28.1618. Epub 2010 Jul 26. Erratum in: J Clin Oncol. 2012 May 20;30(15):1896. [http://jco.ascopubs.org/content/28/27/4184.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20660832 PubMed]
-==C-VAMP -> high-dose Melphalan (Alkeran)==
-C-VAMP: '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''incristine, '''<u>A</u>'''driamycin, '''<u>M</u>'''ethyl'''<u>P</u>'''rednisolone
-===Regimen - multiple myeloma high-dose therapy===
-====Induction therapy====
-*[[Doxorubicin (Adriamycin)]] 9 mg/m2/day IV continuous infusion over 4 days (total dose per cycle: 36 mg/m2) on days 1-4
-*[[Vincristine (Oncovin)]] 0.4 mg IV once daily on days 1-4 (total dose per cycle: 1.6 mg)
-*[[Methylprednisolone (Solumedrol)]] 1000 mg/m2 (maximum dose per cycle of 1500 mg) PO/IV once daily on days 1-5
-*[[Cyclophosphamide (Cytoxan)]] 500 mg IV once daily on days 1, 8, 15
-**Cyclophosphamide was omitted in patients with a serum creatinine >3.4 mg/dL
-'''21-day cycles, given until maximal response was achieved. A minimum of 3 cycles given before stem cell harvest.'''
-*Stem cell mobilization was performed with administration of [[Cyclophosphamide (Cytoxan)]] 2000-4000 mg/m2 IV with hydration and [[Filgrastim (Neupogen)|G-CSF]] on days 5-12
-====Melphalan (Alkeran) & transplant====
-*[[Melphalan (Alkeran)]] 200 mg/m2 IV (no additional details given)
-*Peripheral blood stem cells infused on day 0, 24 hours after melphalan
-*[[Methylprednisolone (Solumedrol)]] 1500 mg IV once daily on days 0-3
-An alternative to the above melphalan option was:
-*Bone marrow autograft
-*Total body irradiation (TBI)
-*[[Melphalan (Alkeran)]] 140 mg/m2 IV (no additional details given)
-*[[Methylprednisolone (Solumedrol)]] 1500 mg IV once daily on days 0-3
-====Interferon alfa maintenance therapy====
-*[[Interferon alfa-2a (Roferon-A)]] 3 million units SC three times per week
-===Reference===
-# Child JA, Morgan GJ, Davies FE, Owen RG, Bell SE, Hawkins K, Brown J, Drayson MT, Selby PJ; Medical Research Council Adult Leukaemia Working Party. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. N Engl J Med. 2003 May 8;348(19):1875-83. [http://www.nejm.org/doi/full/10.1056/NEJMoa022340#t=abstract link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12736280 PubMed]
-==High-dose Melphalan (Alkeran)==
-===Regimen - immunoglobulin light-chain (AL) amyloidosis===
-''Eligibility criteria: Biopsy-proven amyloid disease and ≥1 major organ involved, evidence of plasma cell dyscrasia, no heart failure or arrhythmia that cannot be medically managed, cardiac ejection fraction ≥40%, no pleural effusions, supine systolic blood pressure ≥90 mmHg, O2 saturation ≥95% on room air, lung diffusing capacity ≥50% predicted, SWOG performance status ≤2 unless due to neuropathy.''
-*Patients who fulfilled all of these criteria--≤65 years old, cardiac ejection fraction ≥45%, and ≥2.5 x 10<sup>6</sup> CD34+ cells/kg collected--received [[Melphalan (Alkeran)]] 200 mg/m2 total dose IV divided over two consecutive days
-*Patients with at least one of these criteria-->65 years old, cardiac ejection fraction 40-44%, or with 2.0-2.5 x 10<sup>6</sup> CD34+ cells/kg collected received [[Melphalan (Alkeran)]] 140 mg/m2 total dose IV divided over two consecutive days
-*Autologous stem cell infusion occurs 24-72 hours after the last dose of melphalan
-===References===
-# Skinner M, Sanchorawala V, Seldin DC, Dember LM, Falk RH, Berk JL, Anderson JJ, O'Hara C, Finn KT, Libbey CA, Wiesman J, Quillen K, Swan N, Wright DG. High-dose melphalan and autologous stem-cell transplantation in patients with AL amyloidosis: an 8-year study. Ann Intern Med. 2004 Jan 20;140(2):85-93. [http://annals.org/article.aspx?articleid=717091 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/14734330 PubMed]
-==TAM6==
-===Regimen===
-*Total body irradiation (TBI) with a total dose of 10 Gy over 3 days using twice per day fractions
-*[[Cytarabine (Cytosar)]] 1500 mg/m2 IV Q12H x 2 days (total of 4 total doses)
-*[[Melphalan (Alkeran)]] 140 mg/m2 IV
-'''Peripheral stem cells are infused on day 0'''
-Supportive medications:
-"Antimicrobial prophylaxis and use of [[Filgrastim (Neupogen) | G-CSF]] or erythropoietin were permitted according to physician decision."
-===References===
-# Delarue R, Haioun C, Ribrag V, Brice P, Delmer A, Tilly H, Salles G, Van Hoof A, Casasnovas O, Brousse N, Lefrere F, Hermine O; for the Groupe d'Etude des Lymphomes de l'Adulte (GELA). CHOP and DHAP plus rituximab followed by autologous stem cell transplantation in mantle cell lymphoma: a phase 2 study from the Groupe d'Etude des Lymphomes de l'Adulte. Blood. 2013 Jan 3;121(1):48-53. Epub 2012 Jun 20. [http://bloodjournal.hematologylibrary.org/content/121/1/48.full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22718839 PubMed]
-==VMCP & BVAP -> high-dose Melphalan (Alkeran)==
-VMCP: '''<u>V</u>'''incristine, '''<u>M</u>'''elphalan, '''<u>C</u>'''yclophosphamide, '''<u>P</u>'''rednisone
-<br>BVAP: '''<u>B</u>'''iCNU, '''<u>V</u>'''incristine, '''<u>A</u>'''driamycin, '''<u>P</u>'''rednisone
-===Regimen - multiple myeloma high-dose therapy===
-====VMCP induction therapy====
-*[[Vincristine (Oncovin)]] 1 mg IV once on day 1
-*[[Melphalan (Alkeran)]] 5 mg/m2 PO once daily on days 1-4
-*[[Cyclophosphamide (Cytoxan)]] 110 mg/m2 PO once daily on days 1-4
-*[[Prednisone (Sterapred)]] 60 mg/m2 PO once daily on days 1-4
-'''21-day cycles x 2-3 cycles, given in an alternating fashion with BVAP'''
-====BVAP induction therapy====
-*[[Vincristine (Oncovin)]] 1 mg IV once on day 1
-*[[Carmustine (BiCNU)]] 30 mg/m2 IV once on day 1
-*[[Doxorubicin (Adriamycin)]] 30 mg/m2 IV once on day 1
-*[[Prednisone (Sterapred)]] 60 mg/m2 PO once daily on days 1-4
-'''21-day cycles x 2-3 cycles, given in an alternating fashion with VMCP'''
-'''VMCP and BVAP are given in an alternating fashion x a total of 4-6 cycles'''; patients with a [[performance status|WHO performance status]] <3, creatinine <1.7 mg/dL (150 μmol/L), and bone marrow (collected after cycle 4) with greater than 200 million nucleated cells/kg would proceed to melphalan, total body irradiation (TBI), and transplant:
-====Melphalan (Alkeran), TBI, and transplant====
-*[[Melphalan (Alkeran)]] 140 mg/m2 IV (no other details given about its administration)
-*Total body irradiation (TBI) with a total dose of 8 Gy given over 4 days in 4 fractions, without lung shielding
-*Autologous hematopoietic stem cell transplant after melphalan and TBI
-*[[Interferon alfa-2b (Intron-A)‎|Interferon alfa]] treatment started after transplant when ANC >1500/mm3 and platelets >75,000/mm3
-===References===
-# Attal M, Harousseau JL, Stoppa AM, Sotto JJ, Fuzibet JG, Rossi JF, Casassus P, Maisonneuve H, Facon T, Ifrah N, Payen C, Bataille R. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome. N Engl J Med. 1996 Jul 11;335(2):91-7. [http://www.nejm.org/doi/full/10.1056/NEJM199607113350204 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/8649495 PubMed]
-=Allogeneic (allo) stem cell transplant=
-==BEAM==
-BEAM: '''<u>B</u>'''iCNU, '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C, '''<u>M</u>'''elphalan
-===Regimen===
-''Day 0 is the day of transplantation.''
-*[[Carmustine (BiCNU)]] 300 mg/m2 IV on day -6
-*[[Etoposide (Vepesid)]] 200 mg/m2 IV BID on days -5 to -2
-*[[Cytarabine (Cytosar)]] 200 mg/m2 IV BID on days -5 to -2
-*[[Melphalan (Alkeran)]] 140 mg/m2 IV on day -1
-Supportive medications:
-*[[Filgrastim (Neupogen)]] 5 mcg/kg SC daily, starting day +7 and continued until engraftment
-*GVHD prophylaxis with tacrolimus and methotrexate
-*"Prophylactic antibiotics"
-===References===
-# Przepiorka D, van Besien K, Khouri I, Hagemeister F, Samuels B, Folloder J, Ueno NT, Molldrem J, Mehra R, Körbling M, Giralt S, Gajewski J, Donato M, Cleary K, Claxton D, Braunschweig I, Andersson B, Anderlini P, Champlin R. Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma. Ann Oncol. 1999 May;10(5):527-32. [http://annonc.oxfordjournals.org/content/10/5/527.long link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10416001 PubMed]
-==Busulfan & Cyclophosphamide (BuCy)==
-===Regimen===
-''Day 0 is the day of transplantation.''
-*[[Busulfan (Myleran)]] 3.2 mg/kg IV daily on days -7 to -4
-*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV daily on days -3 and -2
-Supportive medications:
-*"Cyclosporine alone or cyclosporine plus methotrexate according to the discretion of the attending physician"
-*[[Filgrastim (Neupogen)]] 450 mcg SC daily, starting day +5 and continued until ANC > 3,000
-===References===
-# Lee JH, Joo YD, Kim H, Ryoo HM, Kim MK, Lee GW, Lee JH, Lee WS, Park JH, Bae SH, Hyun MS, Kim DY, Kim SD, Min YJ, Lee KH. Randomized trial of myeloablative conditioning regimens: busulfan plus cyclophosphamide versus busulfan plus fludarabine. J Clin Oncol. 2013 Feb 20;31(6):701-9. doi:10.1200/JCO.2011.40.2362. Epub 2012 Nov 5. [http://jco.ascopubs.org/content/31/6/701.full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/23129746 PubMed]
-==Busulfan & Fludarabine (Flu/Bu; BuFlu)==
-===Regimen #1, Russell, et al. 2002 (Flu/Bu)===
-''Day 0 is the day of transplantation.''
-*[[Fludarabine (Fludara)]] 50 mg/m2 IV daily on days -6 to -2
-*[[Busulfan (Myleran)]] 3.2 mg/kg (ideal body weight) IV daily over 3 hours on days -5 to -2
-Supportive medications:
-*Phenytoin (Dilantin) "loading" PO/IV, dosed to maintain therapeutic levels of 40-80 umol/L on days -5 to -2
-*Ciprofloxacin (Cipro) 500 mg PO BID as prophylaxis
-*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] (dose not specified in reference, but assume 160/800 mg dose) PO 2 times a week as PCP prophylaxis
-*No routine fungal prophylaxis
-*No routine use of growth factors
-*CMV negative blood
-Acute GVHD prophylaxis:
-*[[Antithymocyte globulin (ATG)|Antithymocyte globulin (Thymoglobulin, rabbit ATG)]] 0.5 mg/kg IV on day -2; 2 mg/kg/day IV on days -1 and 0 (total dose of 4.5 mg/kg)
-*[[Cyclosporine modified (Neoral)]] or [[Cyclosporine non-modified (Sandimmune)]] PO/IV BID, with doses adjusted to maintain cyclosporine levels of 150-400 umol/L
-*[[Methotrexate (MTX)]] 15 mg/m2 on day 1; 10 mg/m2 on days 3, 6, 11
-*[[Folinic acid (Leucovorin)]] 5 mg started 24 hours after each dose of methotrexate and continued Q6H until 12 hours before the next dose of methotrexate
-===Regimen #2, Lee, et al. 2013 (BuFlu)===
-''Day 0 is the day of transplantation.''
-*[[Busulfan (Myleran)]] 3.2 mg/kg IV daily on days -7 to -4
-*[[Fludarabine (Fludara)]] 30 mg/m2 IV daily on days -6 to -2
-Supportive medications:
-*"Cyclosporine alone or cyclosporine plus methotrexate according to the discretion of the attending physician"
-*[[Filgrastim (Neupogen)]] 450 mcg SC daily, starting day +5 and continued until ANC > 3,000
-===References===
-# Russell JA, Tran HT, Quinlan D, Chaudhry A, Duggan P, Brown C, Stewart D, Ruether JD, Morris D, Glick S, Gyonyor E, Andersson BS. Once-daily intravenous busulfan given with fludarabine as conditioning for allogeneic stem cell transplantation: study of pharmacokinetics and early clinical outcomes. Biol Blood Marrow Transplant. 2002;8(9):468-76. [http://www.bbmt.org/article/S1083-8791%2802%2950007-0/abstract link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12374451 PubMed]
-# Lee JH, Joo YD, Kim H, Ryoo HM, Kim MK, Lee GW, Lee JH, Lee WS, Park JH, Bae SH, Hyun MS, Kim DY, Kim SD, Min YJ, Lee KH. Randomized trial of myeloablative conditioning regimens: busulfan plus cyclophosphamide versus busulfan plus fludarabine. J Clin Oncol. 2013 Feb 20;31(6):701-9. doi:10.1200/JCO.2011.40.2362. Epub 2012 Nov 5. [http://jco.ascopubs.org/content/31/6/701.full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/23129746 PubMed]
-==Low-dose TBI and Fludarabine==
-===Regimen===
-''Day 0 is the day of transplantation.''
-*[[Fludarabine (Fludara)]] 30 mg/m2 IV daily on days -4 to -2
-*Total body irradiation (TBI) 2 Gy at a rate of 0.07-0.20 Gy/min on day 0
-Supportive medications for GVHD prophylaxis:
-*"Postgrafting immunosuppression consisted of [[Cyclosporine non-modified (Sandimmune) | cyclosporine]] or [[Tacrolimus (Prograf) | tacrolimus]] combined with [[Mycophenolate mofetil (CellCept) | mycophenolate mofetil]]," further details not specified
-===References===
-# Gyurkocza B, Storb R, Storer BE, Chauncey TR, Lange T, Shizuru JA, Langston AA, Pulsipher MA, Bredeson CN, Maziarz RT, Bruno B, Petersen FB, Maris MB, Agura E, Yeager A, Bethge W, Sahebi F, Appelbaum FR, Maloney DG, Sandmaier BM. Nonmyeloablative allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. J Clin Oncol. 2010 Jun 10;28(17):2859-67. doi:10.1200/JCO.2009.27.1460. Epub 2010 May 3. [http://jco.ascopubs.org/content/28/17/2859.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20439626 PubMed]