Difference between revisions of "Transplant conditioning regimens"

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'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].'''
 
'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|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 [[How_to_contribute|invited to contribute to the site]].
+
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]].
  
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<big>'''Unlike the other chemotherapy regimen pages, this one is not disease-specific. Rather, this is a gathering point for all transplant conditioning regimens, which will eventually also be available under their respective disease-specific pages. However, this page will remain as a central reference for these types of regimens. Unless otherwise specified, the day of hematopoietic cell re-infusion is by convention day 0.'''</big>
+
<big>'''Unlike the other chemotherapy regimen pages, this one is not disease-specific. Rather, this is a gathering point for all transplant mobilization & conditioning regimens, the latter of which will eventually also be available under their respective disease-specific pages. However, this page will remain as a central reference for these types of regimens. Unless otherwise specified, the day of hematopoietic cell re-infusion is by convention day 0.'''</big>
  
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
|-
 
|-
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|<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} regimens on this page</b></font></div>
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|<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} regimens on this page</b></font></div>
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<div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} variants on this page</b></font></div>
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<div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} variants on this page</b></font></div>
 
|}
 
|}
 
{{TOC limit|limit=3}}
 
{{TOC limit|limit=3}}
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|-
 
|-
 
|}
 
|}
−
 
+
====Mobilization regimen====
−
*[[Cyclophosphamide (Cytoxan)]] 3000 mg/m2 IV once
+
*[[Cyclophosphamide (Cytoxan)]] 3000 mg/m<sup>2</sup> IV once
 
*[[Filgrastim (Neupogen)]] 10 mcg/kg SC once per day and continued until ≥ 4 × 10<sup>6</sup>/kg CD34+ cells are collected
 
*[[Filgrastim (Neupogen)]] 10 mcg/kg SC once per day and continued until ≥ 4 × 10<sup>6</sup>/kg CD34+ cells are collected
  
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|-
 
|-
 
|}
 
|}
−
 
+
====Mobilization regimen====
−
*[[Cytarabine (Cytosar)]] 3000 mg/m2 IV once per day on days 1 & 2
+
*[[Cytarabine (Cytosar)]] 3000 mg/m<sup>2</sup> IV once per day on days 1 & 2
 
*[[Filgrastim (Neupogen)]] 10 mcg/kg SC once per day starting on day 4 and continued until stem cell collection complete
 
*[[Filgrastim (Neupogen)]] 10 mcg/kg SC once per day starting on day 4 and continued until stem cell collection complete
  
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|-
 
|-
 
|}
 
|}
−
 
+
====Mobilization regimen====
−
*[[Cytarabine (Cytosar)]] 1000 mg/m2 IV Q12H on days 1 & 2
+
*[[Cytarabine (Cytosar)]] 1000 mg/m<sup>2</sup> IV Q12H on days 1 & 2
−
*[[Ifosfamide (Ifex)]] 1500 mg/m2 IV once per day on days 1 to 3
+
*[[Ifosfamide (Ifex)]] 1500 mg/m<sup>2</sup> IV once per day on days 1 to 3
 
*[[Filgrastim (Neupogen)]] (dose/frequency not specified)
 
*[[Filgrastim (Neupogen)]] (dose/frequency not specified)
  
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|}
 
|}
 
''Target collection dose not described; mobilization took place after the first course of [[CNS_lymphoma#CYVE|CYVE salvage for CNS lymphoma]].''
 
''Target collection dose not described; mobilization took place after the first course of [[CNS_lymphoma#CYVE|CYVE salvage for CNS lymphoma]].''
−
 
+
====Mobilization regimen====
 
*[[Cytarabine (Cytosar)]] as follows:
 
*[[Cytarabine (Cytosar)]] as follows:
−
**2000 mg/m2 IV over 3 hours once per day on days 2 to 5
+
**2000 mg/m<sup>2</sup> IV over 3 hours once per day on days 2 to 5
−
**50 mg/m2 IV over 12 hours once per day on days 1 to 5
+
**50 mg/m<sup>2</sup> IV over 12 hours once per day on days 1 to 5
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV over 2 hours once per day on days 2 to 5
+
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV over 2 hours once per day on days 2 to 5
 
*[[Filgrastim (Neupogen)]] 5 μg/kg SC once per day starting 48 hours after end of chemotherapy
 
*[[Filgrastim (Neupogen)]] 5 μg/kg SC once per day starting 48 hours after end of chemotherapy
  
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|-
 
|-
 
|}
 
|}
−
 
+
====Mobilization regimen====
−
*[[Ifosfamide (Ifex)]] 2000 mg/m2 IV over 2 hours once per day on days 1 to 4
+
*[[Ifosfamide (Ifex)]] 2000 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 4
−
*[[Gemcitabine (Gemzar)]] 800 mg/m2 IV once per day on days 1 & 4
+
*[[Gemcitabine (Gemzar)]] 800 mg/m<sup>2</sup> IV once per day on days 1 & 4
−
*[[Vinorelbine (Navelbine)]] 20 mg/m2 IV once on day 1
+
*[[Vinorelbine (Navelbine)]] 20 mg/m<sup>2</sup> IV once on day 1
 
*[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 4
 
*[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 4
  
−
Supportive medications:
+
====Supportive medications====
−
*[[Mesna (Mesnex)]] 900 mg/m2 IV at 0, 2, 4 hours after [[Ifosfamide (Ifex)]] on days 1 to 4
+
*[[Mesna (Mesnex)]] 900 mg/m<sup>2</sup> IV at 0, 2, 4 hours after [[Ifosfamide (Ifex)]] on days 1 to 4
 
*[[Lenograstim (Granocyte)]] 263 µg SC once per day on days 7 until at least 3 x 10<sup>6</sup> CD34+ cells per kg of body weight were collected
 
*[[Lenograstim (Granocyte)]] 263 µg SC once per day on days 7 until at least 3 x 10<sup>6</sup> CD34+ cells per kg of body weight were collected
  
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|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Carmustine (BiCNU)]] 400 mg/m2 IV once on day 50
+
*[[Carmustine (BiCNU)]] 400 mg/m<sup>2</sup> IV once on day 50
 
*[[Thiotepa (Thioplex)]] 5 mg/kg (route not specified) once per day on days 51 & 52
 
*[[Thiotepa (Thioplex)]] 5 mg/kg (route not specified) once per day on days 51 & 52
  
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|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Carmustine (BiCNU)]] 400 mg/m2 IV once on day 1
+
*[[Carmustine (BiCNU)]] 400 mg/m<sup>2</sup> IV once on day 1
 
*[[Thiotepa (Thioplex)]] 5 mg/kg (route not specified) BID on days 2 & 3
 
*[[Thiotepa (Thioplex)]] 5 mg/kg (route not specified) BID on days 2 & 3
  
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BEAC: '''<u>B</u>'''iCNU (Carmustine), '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C (Cytarabine), '''<u>C</u>'''yclophosphamide
 
BEAC: '''<u>B</u>'''iCNU (Carmustine), '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C (Cytarabine), '''<u>C</u>'''yclophosphamide
  
−
===Regimen {{#subobject:728b1c|Variant=1}}===
+
===Regimen {{#subobject:728b1c|Variant=1}}===
 
{| border="1" style="text-align:center;" !align="left"  
 
{| border="1" style="text-align:center;" !align="left"  
 
|'''Study'''
 
|'''Study'''
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''Treatment in PARMA preceded by [[Diffuse_large_B-cell_lymphoma#DHAP|DHAP x 2]].
 
''Treatment in PARMA preceded by [[Diffuse_large_B-cell_lymphoma#DHAP|DHAP x 2]].
−
 
+
====Preparative regimen====
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -7
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -7
−
*[[Etoposide (Vepesid)]] 800 mg/m2 IV once per day on days -6 to -3
+
*[[Etoposide (Vepesid)]] 800 mg/m<sup>2</sup> IV once per day on days -6 to -3
−
*[[Cytarabine (Cytosar)]] 800 mg/m2 IV once per day on days -6 to -3
+
*[[Cytarabine (Cytosar)]] 800 mg/m<sup>2</sup> IV once per day on days -6 to -3
 
*[[Cyclophosphamide (Cytoxan)]] 35 mg/kg IV once per day on days -6 to -3
 
*[[Cyclophosphamide (Cytoxan)]] 35 mg/kg IV once per day on days -6 to -3
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day starting on day +1, continued until there are 3 consecutive days with ANC ≥1000
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day 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"
 
*Prophylaxis against opportunistic infections and management of febrile neutropenia per "active protocols"
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|-
 
|-
 
|}
 
|}
 +
====Preparative regimen====
 +
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -6
 +
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV once per day on days -5 to -2
 +
*[[Cytarabine (Cytosar)]] 200 mg/m<sup>2</sup> IV Q12H on days -5 to -2
 +
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -1
  
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -6
+
====Supportive medications====
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV once per day on days -5 to -2
 
−
*[[Cytarabine (Cytosar)]] 200 mg/m2 IV Q12H on days -5 to -2
 
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day -1
 
−
 
 
−
Supportive medications:
 
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day starting on day +4 "until engraftment"
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day starting on day +4 "until engraftment"
 
*[[Valacyclovir (Valtrex)]] (dose not specified) for one month
 
*[[Valacyclovir (Valtrex)]] (dose not specified) for one month
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|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -6
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -6
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV once per day on days -5 to -2
+
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV once per day on days -5 to -2
−
*[[Cytarabine (Cytosar)]] 200 mg/m2 IV once per day on days -5 to -2
+
*[[Cytarabine (Cytosar)]] 200 mg/m<sup>2</sup> IV once per day on days -5 to -2
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day -1
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -1
  
 
===Regimen #3 {{#subobject:16f7a3|Variant=1}}===
 
===Regimen #3 {{#subobject:16f7a3|Variant=1}}===
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border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 
|-
 
|-
−
|[http://bloodjournal.hematologylibrary.org/content/107/12/4623.long Stewart et al. 2006]
+
|[http://www.bloodjournal.org/content/107/12/4623.long Stewart et al. 2006]
 
|<span  
 
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
Line 346: Line 346:
 
|-
 
|-
 
|}
 
|}
 +
====Preparative regimen====
 +
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -6
 +
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV Q12H on days -5 to -2 (8 total doses)
 +
*[[Cytarabine (Cytosar)]] 200 mg/m<sup>2</sup> IV Q12H on days -5 to -2 (8 total doses)
 +
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -1
  
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -6
+
====Supportive medications====
−
*[[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 once on day -1
 
−
 
 
−
Supportive medications:
 
 
*Patients <70 kg: [[Filgrastim (Neupogen)]] 300 mcg SC once per day starting on day +7 after stem cell transplant
 
*Patients <70 kg: [[Filgrastim (Neupogen)]] 300 mcg SC once per day 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 once per day 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 once per day starting on day +7 after stem cell transplant
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|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day 1
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day 1
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV once per day on days 2 to 5  
+
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV once per day on days 2 to 5  
−
*[[Cytarabine (Cytosar)]] 100 mg/m2 IV Q12H on days 2 to 5
+
*[[Cytarabine (Cytosar)]] 100 mg/m<sup>2</sup> IV Q12H on days 2 to 5
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day 6
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day 6
  
 
'''Day of transplant is not specified'''
 
'''Day of transplant is not specified'''
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''Paper did not specify which day peripheral blood stem cells were administered.''
 
''Paper did not specify which day peripheral blood stem cells were administered.''
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day 1
+
====Preparative regimen====
−
*[[Etoposide (Vepesid)]] 150 mg/m2 IV Q12H on days 2 to 5 (8 total doses)
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day 1
−
*[[Cytarabine (Cytosar)]] 200 mg/m2 IV Q12H on days 2 to 5 (8 total doses)
+
*[[Etoposide (Vepesid)]] 150 mg/m<sup>2</sup> IV Q12H on days 2 to 5 (8 total doses)
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day 1
+
*[[Cytarabine (Cytosar)]] 200 mg/m<sup>2</sup> IV Q12H on days 2 to 5 (8 total doses)
 +
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day 1
  
 
===Regimen #6 {{#subobject:d7b00a|Variant=1}}===
 
===Regimen #6 {{#subobject:d7b00a|Variant=1}}===
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|-
 
|-
 
|}
 
|}
 +
====Preparative regimen====
 +
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -6
 +
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV once per day on days -5 to -2
 +
*[[Cytarabine (Cytosar)]] 400 mg/m<sup>2</sup> IV once per day on days -5 to -2
 +
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -1
  
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -6
+
====Supportive medications====
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV once per day on days -5 to -2
 
−
*[[Cytarabine (Cytosar)]] 400 mg/m2 IV once per day on days -5 to -2
 
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day -1
 
−
 
 
−
Supportive medications:
 
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day starting on day +1, continued until there are 3 consecutive days with ANC =1000
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day 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"
 
*Prophylaxis against opportunistic infections and management of febrile neutropenia per "active protocols"
Line 442: Line 443:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -7
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -7
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV BID on days -6 to -3
+
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV BID on days -6 to -3
−
*[[Cytarabine (Cytosar)]] 200 mg/m2 IV BID on days -6 to -3
+
*[[Cytarabine (Cytosar)]] 200 mg/m<sup>2</sup> IV BID on days -6 to -3
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day -2
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -2
  
 
===References===
 
===References===
Line 453: Line 454:
 
# Zinzani PL, Tani M, Gabriele A, Gherlinzoni F, De Vivo A, Ricci P, Bandini G, Lemoli RM, Motta MR, Rizzi S, Guidice V, Zompatori M, Stefoni V, Alinari L, Musuraca G, Marchi E, Bassi S, Conte R, Pileri S, Tura S, Baccarani M. High-dose therapy with autologous transplantation for aggressive non-Hodgkin's lymphoma: the Bologna experience. Leuk Lymphoma. 2004 Feb;45(2):321-6. [http://www.ncbi.nlm.nih.gov/pubmed/15101718 PubMed]
 
# Zinzani PL, Tani M, Gabriele A, Gherlinzoni F, De Vivo A, Ricci P, Bandini G, Lemoli RM, Motta MR, Rizzi S, Guidice V, Zompatori M, Stefoni V, Alinari L, Musuraca G, Marchi E, Bassi S, Conte R, Pileri S, Tura S, Baccarani M. High-dose therapy with autologous transplantation for aggressive non-Hodgkin's lymphoma: the Bologna experience. Leuk Lymphoma. 2004 Feb;45(2):321-6. [http://www.ncbi.nlm.nih.gov/pubmed/15101718 PubMed]
 
# 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]
 
# 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] content property of [http://hemonc.org HemOnc.org]
+
# 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://www.bloodjournal.org/content/107/12/4623.long link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16467197 PubMed] content property of [http://hemonc.org HemOnc.org]
 
# Colombat P, Lemevel A, Bertrand P, Delwail V, Rachieru P, Brion A, Berthou C, Bay JO, Delepine R, Desablens B, Camilleri-Broët S, Linassier C, Lamy T. High-dose chemotherapy with autologous stem cell transplantation as first-line therapy for primary CNS lymphoma in patients younger than 60 years: a multicenter phase II study of the GOELAMS group. Bone Marrow Transplant. 2006 Sep;38(6):417-20. [http://www.nature.com/bmt/journal/v38/n6/full/1705452a.html link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16951691 PubMed]
 
# Colombat P, Lemevel A, Bertrand P, Delwail V, Rachieru P, Brion A, Berthou C, Bay JO, Delepine R, Desablens B, Camilleri-Broët S, Linassier C, Lamy T. High-dose chemotherapy with autologous stem cell transplantation as first-line therapy for primary CNS lymphoma in patients younger than 60 years: a multicenter phase II study of the GOELAMS group. Bone Marrow Transplant. 2006 Sep;38(6):417-20. [http://www.nature.com/bmt/journal/v38/n6/full/1705452a.html link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16951691 PubMed]
 
# '''Retrospective:''' 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]
 
# '''Retrospective:''' 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]
Line 495: Line 496:
  
 
===Regimen {{#subobject:93cb47|Variant=1}}===
 
===Regimen {{#subobject:93cb47|Variant=1}}===
−
<span  
+
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://www.bloodjournal.org/content/115/1/32.long Roussel et al. 2009]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 501: Line 507:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
  
 
''Autologous hematopoetic stem cell transplant on day 0.''
 
''Autologous hematopoetic stem cell transplant on day 0.''
 +
====Preparative regimen====
 +
*[[Bortezomib (Velcade)]] 1 mg/m<sup>2</sup> IV once per day on days -6, -3, 1, 4
 +
*[[Melphalan (Alkeran)]] 200 mg/m<sup>2</sup> IV once on day -2
  
−
*[[Bortezomib (Velcade)]] 1 mg/m2 IV once per day on days -6, -3, 1, 4
+
====Supportive medications====
−
*[[Melphalan (Alkeran)]] 200 mg/m2 IV once on day -2
 
−
 
 
−
Supportive medications:
 
 
*"All patients received standard supportive care measures"
 
*"All patients received standard supportive care measures"
  
 
===References===
 
===References===
−
# Roussel M, Moreau P, Huynh A, Mary JY, Danho C, Caillot D, Hulin C, Fruchart C, Marit G, Pégourié B, Lenain P, Araujo C, Kolb B, Randriamalala E, Royer B, Stoppa AM, Dib M, Dorvaux V, Garderet L, Mathiot C, Avet-Loiseau H, Harousseau JL, Attal M; Intergroupe Francophone du Myélome (IFM). Bortezomib and high-dose melphalan as conditioning regimen before autologous stem cell transplantation in patients with de novo multiple myeloma: a phase 2 study of the Intergroupe Francophone du Myelome (IFM). Blood. 2010 Jan 7;115(1):32-7. Epub 2009 Nov 2. [http://bloodjournal.hematologylibrary.org/content/115/1/32.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19884643 PubMed]  
+
# Roussel M, Moreau P, Huynh A, Mary JY, Danho C, Caillot D, Hulin C, Fruchart C, Marit G, Pégourié B, Lenain P, Araujo C, Kolb B, Randriamalala E, Royer B, Stoppa AM, Dib M, Dorvaux V, Garderet L, Mathiot C, Avet-Loiseau H, Harousseau JL, Attal M; Intergroupe Francophone du Myélome (IFM). Bortezomib and high-dose melphalan as conditioning regimen before autologous stem cell transplantation in patients with de novo multiple myeloma: a phase 2 study of the Intergroupe Francophone du Myelome (IFM). Blood. 2010 Jan 7;115(1):32-7. Epub 2009 Nov 2. [http://www.bloodjournal.org/content/115/1/32.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19884643 PubMed]  
  
 
==Busulfan & Melphalan {{#subobject:484436|Regimen=1}}==
 
==Busulfan & Melphalan {{#subobject:484436|Regimen=1}}==
Line 524: Line 532:
 
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 
|-
 
|-
−
|[http://bloodjournal.hematologylibrary.org/content/121/16/3095.long Yanada et al. 2013]
+
|[http://www.bloodjournal.org/content/121/16/3095.long Yanada et al. 2013]
 
|<span  
 
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
Line 533: Line 541:
 
|-
 
|-
 
|}
 
|}
 +
====Preparative regimen====
 
*[[Busulfan (Myleran)]] 1 mg/kg PO q6h on days -6 to -4
 
*[[Busulfan (Myleran)]] 1 mg/kg PO q6h on days -6 to -4
−
*[[Melphalan (Alkeran)]] 70 mg/m2 IV bolus once per day on days -3 & -2
+
*[[Melphalan (Alkeran)]] 70 mg/m<sup>2</sup> IV bolus once per day on days -3 & -2
  
 
===References===
 
===References===
−
# Yanada M, Tsuzuki M, Fujita H, Fujimaki K, Fujisawa S, Sunami K, Taniwaki M, Ohwada A, Tsuboi K, Maeda A, Takeshita A, Ohtake S, Miyazaki Y, Atsuta Y, Kobayashi Y, Naoe T, Emi N; Japan Adult Leukemia Study Group. Phase 2 study of arsenic trioxide followed by autologous hematopoietic cell transplantation for relapsed acute promyelocytic leukemia. Blood. 2013 Apr 18;121(16):3095-102. Epub 2013 Feb 14. [http://bloodjournal.hematologylibrary.org/content/121/16/3095.long link to original article] '''Contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/23412094 PubMed]
+
# Yanada M, Tsuzuki M, Fujita H, Fujimaki K, Fujisawa S, Sunami K, Taniwaki M, Ohwada A, Tsuboi K, Maeda A, Takeshita A, Ohtake S, Miyazaki Y, Atsuta Y, Kobayashi Y, Naoe T, Emi N; Japan Adult Leukemia Study Group. Phase 2 study of arsenic trioxide followed by autologous hematopoietic cell transplantation for relapsed acute promyelocytic leukemia. Blood. 2013 Apr 18;121(16):3095-102. Epub 2013 Feb 14. [http://www.bloodjournal.org/content/121/16/3095.long link to original article] '''Contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/23412094 PubMed]
  
 
==Bu/TT {{#subobject:e04a91|Regimen=1}}==
 
==Bu/TT {{#subobject:e04a91|Regimen=1}}==
Line 560: Line 569:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
 
*[[Busulfan (Myleran)]] 4 mg/kg PO four times per day on days −8 to −5
 
*[[Busulfan (Myleran)]] 4 mg/kg PO four times per day on days −8 to −5
 
*[[Thiotepa (Thioplex)]] 5 mg/kg IV once per day on days -4 & -3
 
*[[Thiotepa (Thioplex)]] 5 mg/kg IV once per day on days -4 & -3
Line 588: Line 597:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
 
*[[Busulfan (Myleran)]] 3.2 mg/kg IV once per day on days −6, −5, and −4
 
*[[Busulfan (Myleran)]] 3.2 mg/kg IV once per day on days −6, −5, and −4
−
*[[Thiotepa (Thioplex)]] 250 mg/m2 IV once per day on days −9, −8, and −7
+
*[[Thiotepa (Thioplex)]] 250 mg/m<sup>2</sup> IV once per day on days −9, −8, and −7
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days −3 and −2
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days −3 and −2
  
Line 601: Line 610:
 
|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
C-VAMP: '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''incristine, '''<u>A</u>'''driamycin, '''<u>M</u>'''ethyl'''<u>P</u>'''rednisolone
+
C-VAMP: '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''incristine, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>M</u>'''ethyl'''<u>P</u>'''rednisolone
 
===Regimen - multiple myeloma high-dose therapy {{#subobject:e6ae33|Variant=1}}===
 
===Regimen - multiple myeloma high-dose therapy {{#subobject:e6ae33|Variant=1}}===
−
 
+
{| border="1" style="text-align:center;" !align="left"
−
<span  
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|'''Comparator'''
 +
|-
 +
|[http://www.nejm.org/doi/full/10.1056/NEJMoa022340 Child et al. 2003 (MRC Myeloma VII)]
 +
|<span  
 
style="background:#00CD00;
 
style="background:#00CD00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 610: Line 624:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase III</span>
 
border-style:solid;">Phase III</span>
−
 
+
|ABCM
−
====Induction therapy====
+
|-
 +
|}
 +
====C-VAMP portion====
 
*[[Cyclophosphamide (Cytoxan)]] 500 mg IV once per day on days 1, 8, 15
 
*[[Cyclophosphamide (Cytoxan)]] 500 mg IV once per day on days 1, 8, 15
 
**Cyclophosphamide was omitted in patients with a serum creatinine >3.4 mg/dL
 
**Cyclophosphamide was omitted in patients with a serum creatinine >3.4 mg/dL
 
*[[Vincristine (Oncovin)]] 0.4 mg IV once per day on days 1 to 4 (total dose per cycle: 1.6 mg)
 
*[[Vincristine (Oncovin)]] 0.4 mg IV once per day on days 1 to 4 (total dose per cycle: 1.6 mg)
−
*[[Doxorubicin (Adriamycin)]] 9 mg/m2/day IV continuous infusion over 4 days (total dose per cycle: 36 mg/m2) on days 1 to 4
+
*[[Doxorubicin (Adriamycin)]] 9 mg/m<sup>2</sup>/day IV continuous infusion over 4 days (total dose per cycle: 36 mg/m<sup>2</sup>) on days 1 to 4
−
*[[Methylprednisolone (Solumedrol)]] 1000 mg/m2 (maximum dose per cycle of 1500 mg) PO/IV once per day on days 1 to 5
+
*[[Methylprednisolone (Solumedrol)]] 1000 mg/m<sup>2</sup> (maximum dose per cycle of 1500 mg) PO/IV once per day on days 1 to 5
 
   
 
   
 
'''21-day cycles, given until maximal response was achieved. A minimum of 3 cycles given before stem cell harvest.'''
 
'''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 to 4000 mg/m2 IV with hydration and [[Filgrastim (Neupogen)|G-CSF]] on days 5 to 12
+
*Stem cell mobilization was performed with administration of [[Cyclophosphamide (Cytoxan)]] 2000 to 4000 mg/m<sup>2</sup> IV with hydration and [[Filgrastim (Neupogen)|G-CSF]] on days 5 to 12
  
−
====Melphalan (Alkeran) & transplant====
+
====Preparative regimen====
−
*[[Melphalan (Alkeran)]] 200 mg/m2 IV (no additional details given)
+
*[[Melphalan (Alkeran)]] 200 mg/m<sup>2</sup> IV (no additional details given)
 
*Peripheral blood stem cells infused on day 0, 24 hours after melphalan
 
*Peripheral blood stem cells infused on day 0, 24 hours after melphalan
 
*[[Methylprednisolone (Solumedrol)]] 1500 mg IV once per day on days 0 to 3
 
*[[Methylprednisolone (Solumedrol)]] 1500 mg IV once per day on days 0 to 3
Line 630: Line 646:
 
*Bone marrow autograft
 
*Bone marrow autograft
 
*Total body irradiation (TBI)
 
*Total body irradiation (TBI)
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV (no additional details given)
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV (no additional details given)
 
*[[Methylprednisolone (Solumedrol)]] 1500 mg IV once per day on days 0 to 3
 
*[[Methylprednisolone (Solumedrol)]] 1500 mg IV once per day on days 0 to 3
  
Line 637: Line 653:
  
 
===References===
 
===References===
−
# 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]
+
# 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 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12736280 PubMed]
  
 
==CBV {{#subobject:935235|Regimen=1}}==
 
==CBV {{#subobject:935235|Regimen=1}}==
Line 646: Line 662:
 
CBV: '''<u>C</u>'''yclophosphamide, '''<u>B</u>'''iCNU, '''<u>V</u>'''P-16  
 
CBV: '''<u>C</u>'''yclophosphamide, '''<u>B</u>'''iCNU, '''<u>V</u>'''P-16  
  
−
===Regimen #1, Stiff et al. 1998; Damon et al. 2009 {{#subobject:35a696|Variant=1}}===
+
===Regimen #1 {{#subobject:35a696|Variant=1}}===
−
<span  
+
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://jco.ascopubs.org/content/16/1/48.long Stiff et al. 1998]
 +
|<span
 +
style="background:#EEEE00;
 +
padding:3px 6px 3px 6px;
 +
border-color:black;
 +
border-width:2px;
 +
border-style:solid;">Phase II</span>
 +
|-
 +
|[http://jco.ascopubs.org/content/27/36/6101.long Damon et al. 2009 (CALGB 59909)]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 653: Line 682:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
−
 
+
|-
−
*[[Carmustine (BiCNU)]] 15 mg/kg (maximum dose of 550 mg/m2) IV over 1 hour once on day -6
+
|}
 +
====Preparative regimen====
 +
*[[Carmustine (BiCNU)]] 15 mg/kg (maximum dose of 550 mg/m<sup>2</sup>) IV over 1 hour once on day -6
 
*[[Etoposide (Vepesid)]] 60 mg/kg IV over 4 hours once on day -4
 
*[[Etoposide (Vepesid)]] 60 mg/kg IV over 4 hours once on day -4
 
*[[Cyclophosphamide (Cytoxan)]] 100 mg/kg IV over 2 hours once on day -2
 
*[[Cyclophosphamide (Cytoxan)]] 100 mg/kg IV over 2 hours once on day -2
 
*Autologous blood stem cells infused on day 0.
 
*Autologous blood stem cells infused on day 0.
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day starting on day +4, to continue until ANC >5000 once or >1500 twice
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day starting on day +4, to continue until ANC >5000 once or >1500 twice
 
*[[Levofloxacin (Levaquin)]] 500 mg PO once per day, starting on day +2, to continue until ANC =500
 
*[[Levofloxacin (Levaquin)]] 500 mg PO once per day, starting on day +2, to continue until ANC =500
Line 666: Line 697:
 
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] 160/800 mg PO BID on Saturday and Sunday, to continue until 3 months after ASCT
 
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] 160/800 mg PO BID on Saturday and Sunday, to continue until 3 months after ASCT
  
−
===Regimen #2, Zinzani et al. 2003 (CVB) {{#subobject:1ba6d|Variant=1}}===
+
===Regimen #2, "CVB" {{#subobject:1ba6d|Variant=1}}===
−
*[[Cyclophosphamide (Cytoxan)]] 1500 mg/m2 IV once per day on days -6 to -3
+
{| border="1" style="text-align:center;" !align="left"
−
*[[Etoposide (Vepesid)]] 250 mg/m2 IV once per day on days -6 to -4
+
|'''Study'''
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -6
+
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
−
 
+
|-
−
===References===
+
|[http://www.haematologica.org/content/88/5/522.long Zinzani et al. 2003]
−
# Reece DE, Connors JM, Spinelli JJ, Barnett MJ, Fairey RN, Klingemann HG, Nantel SH, O'Reilly S, Shepherd JD, Sutherland HJ, et al. Intensive therapy with cyclophosphamide, carmustine, etoposide +/- cisplatin, and autologous bone marrow transplantation for Hodgkin's disease in first relapse after combination chemotherapy. Blood. 1994 Mar 1;83(5):1193-9. [http://www.bloodjournal.org/content/83/5/1193.long link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/8118023 PubMed]
+
|<span
−
# Stiff PJ, Dahlberg S, Forman SJ, McCall AR, Horning SJ, Nademanee AP, Blume KG, LeBlanc M, Fisher RI. Autologous bone marrow transplantation for patients with relapsed or refractory diffuse aggressive non-Hodgkin's lymphoma: value of augmented preparative regimens--a Southwest Oncology Group trial. J Clin Oncol. 1998 Jan;16(1):48-55. [http://jco.ascopubs.org/content/16/1/48.full.pdf+html link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/9440722 PubMed]
+
style="background:#ff0000;
−
# '''Retrospective:''' Zinzani PL, Tani M, Gabriele A, Gherlinzoni F, de Vivo A, Ricci P, Bandini G, Lemoli RM, Motta MR, Rizzi S, Giudice V, Zompatori M, Stefoni V, Alinari L, Musuraca G, Bassi S, Conte R, Pileri S, Tura S, Baccarani M. High-dose therapy with autologous transplantation for Hodgkin's disease: the Bologna experience. Haematologica. 2003 May;88(5):522-8. [http://www.haematologica.org/content/88/5/522.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12745271 PubMed]  
+
padding:3px 6px 3px 6px;
 +
border-color:black;
 +
border-width:2px;
 +
border-style:solid;">Retrospective</span>
 +
|-
 +
|}
 +
====Preparative regimen====
 +
*[[Cyclophosphamide (Cytoxan)]] 1500 mg/m<sup>2</sup> IV once per day on days -6 to -3
 +
*[[Etoposide (Vepesid)]] 250 mg/m<sup>2</sup> IV once per day on days -6 to -4
 +
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -6
 +
 
 +
===References===
 +
# Reece DE, Connors JM, Spinelli JJ, Barnett MJ, Fairey RN, Klingemann HG, Nantel SH, O'Reilly S, Shepherd JD, Sutherland HJ, et al. Intensive therapy with cyclophosphamide, carmustine, etoposide +/- cisplatin, and autologous bone marrow transplantation for Hodgkin's disease in first relapse after combination chemotherapy. Blood. 1994 Mar 1;83(5):1193-9. [http://www.bloodjournal.org/content/83/5/1193.long link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/8118023 PubMed]
 +
# Stiff PJ, Dahlberg S, Forman SJ, McCall AR, Horning SJ, Nademanee AP, Blume KG, LeBlanc M, Fisher RI. Autologous bone marrow transplantation for patients with relapsed or refractory diffuse aggressive non-Hodgkin's lymphoma: value of augmented preparative regimens--a Southwest Oncology Group trial. J Clin Oncol. 1998 Jan;16(1):48-55. [http://jco.ascopubs.org/content/16/1/48.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/9440722 PubMed]
 +
# '''Retrospective:''' Zinzani PL, Tani M, Gabriele A, Gherlinzoni F, de Vivo A, Ricci P, Bandini G, Lemoli RM, Motta MR, Rizzi S, Giudice V, Zompatori M, Stefoni V, Alinari L, Musuraca G, Bassi S, Conte R, Pileri S, Tura S, Baccarani M. High-dose therapy with autologous transplantation for Hodgkin's disease: the Bologna experience. Haematologica. 2003 May;88(5):522-8. [http://www.haematologica.org/content/88/5/522.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12745271 PubMed]  
 
# Damon LE, Johnson JL, Niedzwiecki D, Cheson BD, Hurd DD, Bartlett NL, Lacasce AS, Blum KA, Byrd JC, Kelly M, Stock W, Linker CA, Canellos GP. Immunochemotherapy and autologous stem-cell transplantation for untreated patients with mantle-cell lymphoma: CALGB 59909. J Clin Oncol. 2009 Dec 20;27(36):6101-8. Epub 2009 Nov 16. [http://jco.ascopubs.org/content/27/36/6101.long link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19917845 PubMed]
 
# Damon LE, Johnson JL, Niedzwiecki D, Cheson BD, Hurd DD, Bartlett NL, Lacasce AS, Blum KA, Byrd JC, Kelly M, Stock W, Linker CA, Canellos GP. Immunochemotherapy and autologous stem-cell transplantation for untreated patients with mantle-cell lymphoma: CALGB 59909. J Clin Oncol. 2009 Dec 20;27(36):6101-8. Epub 2009 Nov 16. [http://jco.ascopubs.org/content/27/36/6101.long link to original article] '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19917845 PubMed]
  
−
==Cyclophosphamide (Cytoxan), Etoposide (Vepesid), TBI {{#subobject:1fcca8|Regimen=1}}==
+
==Cyclophosphamide, Etoposide, TBI {{#subobject:1fcca8|Regimen=1}}==
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
|-
 
|-
Line 683: Line 728:
 
|}
 
|}
 
===Regimen {{#subobject:a79295|Variant=1}}===
 
===Regimen {{#subobject:a79295|Variant=1}}===
−
 
+
{| border="1" style="text-align:center;" !align="left"
−
<span  
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://jco.ascopubs.org/content/16/1/48.long Stiff et al. 1998]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 690: Line 739:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
−
 
+
|-
−
''Autologous hematopoetic stem cell transplant on day 0.''
+
|}
 +
====Preparative regimen====
 
*[[Cyclophosphamide (Cytoxan)]] 100 mg/kg IV over 1 to 2 hours once on day -2
 
*[[Cyclophosphamide (Cytoxan)]] 100 mg/kg IV over 1 to 2 hours once on day -2
 
*[[Etoposide (Vepesid)]] 60 mg/kg IV over 4 hours once on day -4
 
*[[Etoposide (Vepesid)]] 60 mg/kg IV over 4 hours once on day -4
 
*Total body irradiation (TBI) with 150 cGy fractions given twice per day (fractions are at least 5 hours apart) x 8 fractions (total dose: 1200 cGy) over 4 days on days -8 to -5, with lung shielding for the final 600 Gy
 
*Total body irradiation (TBI) with 150 cGy fractions given twice per day (fractions are at least 5 hours apart) x 8 fractions (total dose: 1200 cGy) over 4 days on days -8 to -5, with lung shielding for the final 600 Gy
−
**Note: Table 1 of Stiff et al. 1998 lists the dosage of each fraction as being 120 cGy, in contrast to the body text under "treatment regimen" saying each fraction is 150 cGy. It is believed that the 150 cGy dose is correct since 8 fractions of this results in the correct total dose of 1200 cGy.
+
**Note: Table 1 of Stiff et al. 1998 lists the dosage of each fraction as being 120 cGy, in contrast to the body text under "treatment regimen" saying each fraction is 150 cGy. It is believed that the 150 cGy dose is correct since 8 fractions of this results in the correct total dose of 1200 cGy.
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Diphenhydramine (Benadryl)]] 25 mg (route not specified) once 2 hours before [[Etoposide (Vepesid)]] to prevent allergic reaction
 
*[[Diphenhydramine (Benadryl)]] 25 mg (route not specified) once 2 hours before [[Etoposide (Vepesid)]] to prevent allergic reaction
 
*[[Hydrocortisone (Cortef)]] 100 mg (route not specified) once 2 hours before [[Etoposide (Vepesid)]] to prevent allergic reaction
 
*[[Hydrocortisone (Cortef)]] 100 mg (route not specified) once 2 hours before [[Etoposide (Vepesid)]] to prevent allergic reaction
Line 703: Line 753:
  
 
===References===
 
===References===
−
# Stiff PJ, Dahlberg S, Forman SJ, McCall AR, Horning SJ, Nademanee AP, Blume KG, LeBlanc M, Fisher RI. Autologous bone marrow transplantation for patients with relapsed or refractory diffuse aggressive non-Hodgkin's lymphoma: value of augmented preparative regimens--a Southwest Oncology Group trial. J Clin Oncol. 1998 Jan;16(1):48-55. [http://jco.ascopubs.org/content/16/1/48.full.pdf+html link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/9440722 PubMed]
+
# Stiff PJ, Dahlberg S, Forman SJ, McCall AR, Horning SJ, Nademanee AP, Blume KG, LeBlanc M, Fisher RI. Autologous bone marrow transplantation for patients with relapsed or refractory diffuse aggressive non-Hodgkin's lymphoma: value of augmented preparative regimens--a Southwest Oncology Group trial. J Clin Oncol. 1998 Jan;16(1):48-55. [http://jco.ascopubs.org/content/16/1/48.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/9440722 PubMed]
  
 
==DHAP -> BEAC {{#subobject:6c3b36|Regimen=1}}==
 
==DHAP -> BEAC {{#subobject:6c3b36|Regimen=1}}==
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|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
DHAP: '''<u>D</u>'''examethasone, '''<u>H</u>'''igh-dose '''<u>A</u>'''ra-C (cytarabine), cis'''<u>P</u>'''latin
+
DHAP: '''<u>D</u>'''examethasone, '''<u>H</u>'''igh-dose '''<u>A</u>'''ra-C (Cytarabine), cis'''<u>P</u>'''latin
−
<br>BEAC: '''<u>B</u>'''iCNU, '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C, '''<u>C</u>'''yclophosphamide
+
<br>BEAC: '''<u>B</u>'''iCNU, '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C (Cytarabine), '''<u>C</u>'''yclophosphamide
−
===Regimen, Velasquez, et al. 1988 (DHAP) & Philip, et al. 1991 {{#subobject:a5ff49|Variant=1}}===
+
===Regimen {{#subobject:a5ff49|Variant=1}}===
−
 
+
{| border="1" style="text-align:center;" !align="left"
−
<span
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://www.bloodjournal.org/content/77/7/1587.long Philip et al. 1991 (Parma)]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
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border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
  
 
====DHAP Induction Therapy====
 
====DHAP Induction Therapy====
 
''In Velasquez, et al. 1988, Ara-C/Cytarabine was originally administered "on the third day," but the regimen was subsequently modified so that it was given on day 2 after cisplatin.''  
 
''In Velasquez, et al. 1988, Ara-C/Cytarabine was originally administered "on the third day," but the regimen was subsequently modified so that it was given on day 2 after cisplatin.''  
 
*[[Dexamethasone (Decadron)]] 40 mg PO/IV over 15 minutes once per day on days 1 to 4
 
*[[Dexamethasone (Decadron)]] 40 mg PO/IV over 15 minutes once per day on days 1 to 4
−
*[[Cytarabine (Cytosar)]] 2000 mg/m2 IV over 3 hours on day 2, starting when cisplatin infusion is complete; a second dose of [[Cytarabine (Cytosar)]] 2000 mg/m2 IV over 3 hours is given after the first one
+
*[[Cytarabine (Cytosar)]] 2000 mg/m<sup>2</sup> IV over 3 hours on day 2, starting when cisplatin infusion is complete; a second dose of [[Cytarabine (Cytosar)]] 2000 mg/m<sup>2</sup> IV over 3 hours is given after the first one
−
*[[Cisplatin (Platinol)]] 100 mg/m2 IV continuous infusion over 24 hours on day 1, starting after 6 hours of prehydration
+
*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV continuous infusion over 24 hours on day 1, starting after 6 hours of prehydration
  
−
Supportive Medications:
+
====Supportive medications====
 
*Normal saline solution with mannitol, 50 g/L, at 250 mL/hour IV over 36 hours starting on day 1 prior to cisplatin
 
*Normal saline solution with mannitol, 50 g/L, at 250 mL/hour IV over 36 hours starting on day 1 prior to cisplatin
 
*[[Metoclopramide (Reglan)]] 1 mg/kg "given routinely as antiemetics"
 
*[[Metoclopramide (Reglan)]] 1 mg/kg "given routinely as antiemetics"
 
*[[Diphenhydramine (Benadryl)]] 25 mg IV "given routinely as antiemetics"
 
*[[Diphenhydramine (Benadryl)]] 25 mg IV "given routinely as antiemetics"
  
−
'''21 to 28 day cycles, depending on degree of myelosuppression, for a total of 2 cycles as follows:''' After 1 course of DHAP, if they did not have "clearly progressive disease," patients underwent bone marrow harvest. A second course of DHAP was administered starting 1 day after bone marrow harvest. At day 20 after the second course of DHAP, patients were restaged. Patients who showed a response and had bulky disease at initial relapse then started involved field radiotherapy on day 20 after the second course of DHAP for 5 days per week x 2 weeks. In the original Velasquez, et al. 1988 paper where DHAP was used on its own, treatment continued for 6 to 10 cycles in patient who responded to treatment.
+
'''21 to 28 day cycles, depending on degree of myelosuppression, for a total of 2 cycles as follows:''' After 1 course of DHAP, if they did not have "clearly progressive disease," patients underwent bone marrow harvest. A second course of DHAP was administered starting 1 day after bone marrow harvest. At day 20 after the second course of DHAP, patients were restaged. Patients who showed a response and had bulky disease at initial relapse then started involved field radiotherapy on day 20 after the second course of DHAP for 5 days per week x 2 weeks. In the original Velasquez, et al. 1988 paper where DHAP was used on its own, treatment continued for 6 to 10 cycles in patient who responded to treatment.
  
 
====BEAC conditioning & transplant====
 
====BEAC conditioning & transplant====
−
''BEAC starts on day 35 after the second course of DHAP. Autologous blood stem cells are infused on day 0.''
+
''BEAC starts on day 35 after the second course of DHAP. Autologous blood stem cells are infused on day 0.''
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV over 30 minutes once on day -13
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV over 30 minutes once on day -13
−
*[[Etoposide (Vepesid)]] 100 mg/m2 IV twice per day on days -12 to -7
+
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV twice per day on days -12 to -7
−
*[[Cytarabine (Cytosar)]] 100 mg/m2 IV twice per day on days -12 to -9
+
*[[Cytarabine (Cytosar)]] 100 mg/m<sup>2</sup> IV twice per day on days -12 to -9
 
*[[Cyclophosphamide (Cytoxan)]] 35 mg/kg IV over 60 minutes once per day on days -12 to -9
 
*[[Cyclophosphamide (Cytoxan)]] 35 mg/kg IV over 60 minutes once per day on days -12 to -9
 
*[[Mesna (Mesnex)]] 50 mg/kg IV every day on days -12 to -9 (optional)
 
*[[Mesna (Mesnex)]] 50 mg/kg IV every day on days -12 to -9 (optional)
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|}
 
|}
  
−
''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.''
+
''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.''
−
 
+
====Preparative regimen====
−
*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 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/m<sup>2</sup> 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
+
*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/m<sup>2</sup> total dose IV divided over two consecutive days
 
*Autologous stem cell infusion occurs 24 to 72 hours after the last dose of melphalan
 
*Autologous stem cell infusion occurs 24 to 72 hours after the last dose of melphalan
  
Line 800: Line 856:
 
|}
 
|}
  
−
''A minimum number of 2 × 10^6/kg bw CD34-positive cells were required to proceed.''
+
''A minimum number of 2 × 10<sup>6</sup>/kg bw CD34-positive cells were required to proceed.''
−
 
+
====Preparative regimen====
−
*[[Rituximab (Rituxan)]] 375 mg/m2 IV once on days -8 & -2
+
*[[Rituximab (Rituxan)]] 375 mg/m<sup>2</sup> IV once on days -8 & -2
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -7
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -7
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV BID on days -6 to -3  
+
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV BID on days -6 to -3  
−
*[[Cytarabine (Cytosar)]] 400 mg/m2 IV BID on days -6 to -3
+
*[[Cytarabine (Cytosar)]] 400 mg/m<sup>2</sup> IV BID on days -6 to -3
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day -2
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -2
  
 
'''Autologous blood stem cells are infused on day 0.'''
 
'''Autologous blood stem cells are infused on day 0.'''
  
−
''Patients in the LyMa trial were randomized to [[Mantle_cell_lymphoma#Rituximab_.28Rituxan.29|rituximab maintenance]] versus [[Mantle_cell_lymphoma#Observation_2|observation]].''
+
''Patients in the LyMa trial were then randomized to [[Mantle_cell_lymphoma#Rituximab_.28Rituxan.29|rituximab maintenance]] versus [[Mantle_cell_lymphoma#Observation_2|observation]].''
  
 
===References===
 
===References===
Line 838: Line 894:
 
|}
 
|}
  
−
''A minimum number of 2 × 10^6/kg bw CD34-positive cells were required to proceed.''
+
''A minimum number of 2 × 10<sup>6</sup>/kg bw CD34-positive cells were required to proceed.''
−
 
+
====Preparative regimen====
−
*[[Rituximab (Rituxan)]] 375 mg/m2 IV once on days -8 & -2
+
*[[Rituximab (Rituxan)]] 375 mg/m<sup>2</sup> IV once on days -8 & -2
 
*Total body irradiation (TBI) with a total dose of 12 Gy over 3 days (days -6 to -4) in fractions
 
*Total body irradiation (TBI) with a total dose of 12 Gy over 3 days (days -6 to -4) in fractions
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days -3 & -2
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days -3 & -2
−
 
−
'''Autologous blood stem cells are infused on day 0.'''
 
  
 
===References===
 
===References===
Line 855: Line 909:
 
|}
 
|}
 
===Regimen {{#subobject:4aee7c|Variant=1}}===
 
===Regimen {{#subobject:4aee7c|Variant=1}}===
−
<span  
+
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://www.bloodjournal.org/content/121/1/48.full Delarue et al. 2012]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 861: Line 920:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
  
 +
====Preparative regimen====
 
*Total body irradiation (TBI) with a total dose of 10 Gy over 3 days using twice per day fractions
 
*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)
+
*[[Cytarabine (Cytosar)]] 1500 mg/m<sup>2</sup> IV Q12H x 2 days (total of 4 total doses)
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV  
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV  
  
−
'''Peripheral stem cells are infused on day 0'''
+
====Supportive medications====
−
 
 
−
Supportive medications:
 
 
"Antimicrobial prophylaxis and use of [[Filgrastim (Neupogen) | G-CSF]] or erythropoietin were permitted according to physician decision."
 
"Antimicrobial prophylaxis and use of [[Filgrastim (Neupogen) | G-CSF]] or erythropoietin were permitted according to physician decision."
  
 
===References===
 
===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]
+
# 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://www.bloodjournal.org/content/121/1/48.full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22718839 PubMed]
  
 
==V-BEAM {{#subobject:d6ea18|Regimen=1}}==
 
==V-BEAM {{#subobject:d6ea18|Regimen=1}}==
Line 879: Line 939:
 
|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
V-BEAM: '''<u>V</u>'''elcade, '''<u>B</u>'''iCNU, '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C, '''<u>M</u>'''elphalan
+
V-BEAM: '''<u>V</u>'''elcade (Bortezomib), '''<u>B</u>'''iCNU (Carmustine), '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C (Cytarabine), '''<u>M</u>'''elphalan
  
−
===Regimen, William et al. 2014 {{#subobject:7ef4f|Variant=1}}===
+
===Regimen {{#subobject:7ef4f|Variant=1}}===
−
<span  
+
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://www.bbmt.org/article/S1083-8791(14)00020-2/fulltext William et al. 2014]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 888: Line 953:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
  
 
''Full details not available in abstract; to be added later.''
 
''Full details not available in abstract; to be added later.''
−
 
+
====Preparative regimen====
 
*[[Bortezomib (Velcade)]] on days -11, -8, -5, -2
 
*[[Bortezomib (Velcade)]] on days -11, -8, -5, -2
 
*[[Carmustine (BiCNU)]]  
 
*[[Carmustine (BiCNU)]]  
−
*[[Etoposide (Vepesid)]]
+
*[[Etoposide (Vepesid)]]  
 
*[[Cytarabine (Cytosar)]]  
 
*[[Cytarabine (Cytosar)]]  
 
*[[Melphalan (Alkeran)]]  
 
*[[Melphalan (Alkeran)]]  
Line 906: Line 973:
 
|}
 
|}
 
VMCP: '''<u>V</u>'''incristine, '''<u>M</u>'''elphalan, '''<u>C</u>'''yclophosphamide, '''<u>P</u>'''rednisone
 
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
+
<br>BVAP: '''<u>B</u>'''iCNU (Carmustine), '''<u>V</u>'''incristine, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>P</u>'''rednisone
  
−
===Regimen - multiple myeloma high-dose therapy {{#subobject:f90513|Variant=1}}===
+
===Regimen {{#subobject:f90513|Variant=1}}===
−
<span  
+
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|'''Comparator'''
 +
|-
 +
|[http://www.nejm.org/doi/full/10.1056/NEJM199607113350204 Attal et al. 1996]
 +
|<span  
 
style="background:#00CD00;
 
style="background:#00CD00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 915: Line 988:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase III</span>
 
border-style:solid;">Phase III</span>
 +
|VMCP/BVAP alone
 +
|-
 +
|}
  
−
====VMCP induction therapy====
+
====VMCP portion====
 
*[[Vincristine (Oncovin)]] 1 mg IV once on day 1
 
*[[Vincristine (Oncovin)]] 1 mg IV once on day 1
−
*[[Melphalan (Alkeran)]] 5 mg/m2 PO once per day on days 1 to 4
+
*[[Melphalan (Alkeran)]] 5 mg/m<sup>2</sup> PO once per day on days 1 to 4
−
*[[Cyclophosphamide (Cytoxan)]] 110 mg/m2 PO once per day on days 1 to 4
+
*[[Cyclophosphamide (Cytoxan)]] 110 mg/m<sup>2</sup> PO once per day on days 1 to 4
−
*[[Prednisone (Sterapred)]] 60 mg/m2 PO once per day on days 1 to 4
+
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 4
  
 
'''21-day cycles x 2 to 3 cycles, given in an alternating fashion with BVAP'''
 
'''21-day cycles x 2 to 3 cycles, given in an alternating fashion with BVAP'''
  
−
====BVAP induction therapy====
+
====BVAP portion====
 
*[[Vincristine (Oncovin)]] 1 mg IV once on day 1
 
*[[Vincristine (Oncovin)]] 1 mg IV once on day 1
−
*[[Carmustine (BiCNU)]] 30 mg/m2 IV once on day 1
+
*[[Carmustine (BiCNU)]] 30 mg/m<sup>2</sup> IV once on day 1
−
*[[Doxorubicin (Adriamycin)]] 30 mg/m2 IV once on day 1
+
*[[Doxorubicin (Adriamycin)]] 30 mg/m<sup>2</sup> IV once on day 1
−
*[[Prednisone (Sterapred)]] 60 mg/m2 PO once per day on days 1 to 4
+
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 4
  
 
'''21-day cycles x 2 to 3 cycles, given in an alternating fashion with VMCP'''
 
'''21-day cycles x 2 to 3 cycles, given in an alternating fashion with VMCP'''
Line 934: Line 1,010:
 
'''VMCP and BVAP are given in an alternating fashion x a total of 4 to 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:
 
'''VMCP and BVAP are given in an alternating fashion x a total of 4 to 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====
+
====Preparative regimen====
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV (no other details given about its administration)
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> 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
 
*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
 
*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
+
*[[Interferon alfa-2b (Intron-A)?|Interferon alfa]] treatment started after transplant when ANC >1500/mm<sup>3</sup> and platelets >75,000/mm<sup>3</sup>
  
 
===References===
 
===References===
Line 964: Line 1,040:
 
border-style:solid;">Randomized Phase II, >20 per arm</span>
 
border-style:solid;">Randomized Phase II, >20 per arm</span>
 
|[[Transplant_conditioning_regimens#BEAM|BEAM]]
 
|[[Transplant_conditioning_regimens#BEAM|BEAM]]
−
|-
 
−
!colspan="4" align="center"|
 
 
|-
 
|-
 
|[http://www.haematologica.org/content/99/3/505.full Briones et al. 2013]
 
|[http://www.haematologica.org/content/99/3/505.full Briones et al. 2013]
Line 979: Line 1,053:
  
 
''Patients in Shimoni et al. 2012 had primary induction failure or were chemosensitive to salvage therapy. Patients in Briones et al. 2013 had primary induction failure or were refractory to salvage therapy.''
 
''Patients in Shimoni et al. 2012 had primary induction failure or were chemosensitive to salvage therapy. Patients in Briones et al. 2013 had primary induction failure or were refractory to salvage therapy.''
−
 
+
====Preparative regimen====
−
*[[Rituximab (Rituxan)]] 250 mg/m2 IV once on day -14
+
*[[Rituximab (Rituxan)]] 250 mg/m<sup>2</sup> IV once on day -14
 
*[[Ibritumomab tiuxetan (Zevalin)|Ibritumomab tiuxetan & Yttrium-90 (Zevalin) ]] 0.4 mCi/kg (maximum dose of 32 mCi) IV once on day -14, given after [[Rituximab (Rituxan)]]
 
*[[Ibritumomab tiuxetan (Zevalin)|Ibritumomab tiuxetan & Yttrium-90 (Zevalin) ]] 0.4 mCi/kg (maximum dose of 32 mCi) IV once on day -14, given after [[Rituximab (Rituxan)]]
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -6
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -6
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV once per day on days -5 to -2  
+
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV once per day on days -5 to -2  
−
*[[Cytarabine (Cytosar)]] 200 mg/m2 IV Q12H on days -5 to -2
+
*[[Cytarabine (Cytosar)]] 200 mg/m<sup>2</sup> IV Q12H on days -5 to -2
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day -1
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -1
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day starting on day +4 (Shimoni et al. 2012) or day +7 (Briones et al. 2013) until engraftment
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day starting on day +4 (Shimoni et al. 2012) or day +7 (Briones et al. 2013) until engraftment
 
*[[Valacyclovir (Valtrex)]] (dose not specified) for one month (Shimoni et al. 2012)
 
*[[Valacyclovir (Valtrex)]] (dose not specified) for one month (Shimoni et al. 2012)
 
*[[Acyclovir (Zovirax)]] (dose not specified) for one month (Briones et al. 2013)
 
*[[Acyclovir (Zovirax)]] (dose not specified) for one month (Briones et al. 2013)
 
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] (dose/frequency not specified) for six months (3 months in Briones et al. 2013)
 
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] (dose/frequency not specified) for six months (3 months in Briones et al. 2013)
−
 
−
'''Autologous blood stem cells are infused on day 0'''
 
  
 
===Regimen #2 {{#subobject:e7f161|Variant=1}}===
 
===Regimen #2 {{#subobject:e7f161|Variant=1}}===
Line 1,010: Line 1,082:
 
|}
 
|}
 
''This regimen is intended for upfront consolidation. Patients achieved at least a PR to [[Diffuse_large_B-cell_lymphoma#ACVBP-R|R-ACVBP]] or [[Diffuse_large_B-cell_lymphoma#R-CHOP|R-CHOP]].''
 
''This regimen is intended for upfront consolidation. Patients achieved at least a PR to [[Diffuse_large_B-cell_lymphoma#ACVBP-R|R-ACVBP]] or [[Diffuse_large_B-cell_lymphoma#R-CHOP|R-CHOP]].''
−
 
+
====Preparative regimen====
−
*[[Rituximab (Rituxan)]] 250 mg/m2 IV once per day on days -21 & -14
+
*[[Rituximab (Rituxan)]] 250 mg/m<sup>2</sup> IV once per day on days -21 & -14
 
*[[Ibritumomab tiuxetan (Zevalin)|Ibritumomab tiuxetan & Yttrium-90 (Zevalin) ]] 0.4 mCi/kg (maximum dose of 32 mCi) IV once on day -14, given after [[Rituximab (Rituxan)]]
 
*[[Ibritumomab tiuxetan (Zevalin)|Ibritumomab tiuxetan & Yttrium-90 (Zevalin) ]] 0.4 mCi/kg (maximum dose of 32 mCi) IV once on day -14, given after [[Rituximab (Rituxan)]]
 
**Dose reduced to 0.3 mCi/kg if platelet count was > 100k and less than 150k.
 
**Dose reduced to 0.3 mCi/kg if platelet count was > 100k and less than 150k.
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -7
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -7
−
*[[Etoposide (Vepesid)]] 100 mg/m2 IV once per day on days -6 to -3  
+
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days -6 to -3  
−
*[[Cytarabine (Cytosar)]] 200 mg/m2 IV Q12H on days -6 to -3
+
*[[Cytarabine (Cytosar)]] 200 mg/m<sup>2</sup> IV Q12H on days -6 to -3
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day -2
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -2
  
−
Supportive medications: according to standard use
+
====Supportive medications====
−
 
+
*"According to standard use"
−
'''Autologous blood stem cells are infused on day 0'''
 
  
 
===References===
 
===References===
Line 1,035: Line 1,106:
 
|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
BEAM: '''<u>B</u>'''iCNU, '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C, '''<u>M</u>'''elphalan
+
BEAM: '''<u>B</u>'''iCNU (Carmustine), '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C (Cytarabine), '''<u>M</u>'''elphalan
  
 
===Regimen {{#subobject:a8d4a|Variant=1}}===
 
===Regimen {{#subobject:a8d4a|Variant=1}}===
−
<span  
+
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://annonc.oxfordjournals.org/content/10/5/527.long Przepiorka et al. 1999]
 +
|<span
 +
style="background:#EEEE00;
 +
padding:3px 6px 3px 6px;
 +
border-color:black;
 +
border-width:2px;
 +
border-style:solid;">Phase II</span>
 +
|-
 +
|[http://informahealthcare.com/doi/full/10.3109/10428194.2013.838233 Sobol et al. 2013]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 1,044: Line 1,128:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
  
−
''Day 0 is the day of transplantation.''
+
====Preparative regimen====
−
*[[Carmustine (BiCNU)]] 300 mg/m2 IV once on day -6
+
*[[Carmustine (BiCNU)]] 300 mg/m<sup>2</sup> IV once on day -6
−
*[[Etoposide (Vepesid)]] 200 mg/m2 IV BID on days -5 to -2
+
*[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> IV BID on days -5 to -2
−
*[[Cytarabine (Cytosar)]] 200 mg/m2 IV BID on days -5 to -2
+
*[[Cytarabine (Cytosar)]] 200 mg/m<sup>2</sup> IV BID on days -5 to -2
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once on day -1
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -1
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day +7 and continued until engraftment
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day +7 and continued until engraftment
 
*GVHD prophylaxis with [[Tacrolimus (Prograf)]] and [[Methotrexate (MTX)]]
 
*GVHD prophylaxis with [[Tacrolimus (Prograf)]] and [[Methotrexate (MTX)]]
Line 1,083: Line 1,169:
 
====Preparative regimen====
 
====Preparative regimen====
 
''Note: the bendamustine infusion instructions are for the Treanda formulation, which was discontinued on 3/31/2016.''
 
''Note: the bendamustine infusion instructions are for the Treanda formulation, which was discontinued on 3/31/2016.''
−
*[[Bendamustine]] 130 mg/m2 IV over 60 minutes once per day on days -5 to -3
+
*[[Bendamustine]] 130 mg/m<sup>2</sup> IV over 60 minutes once per day on days -5 to -3
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV over 30 minutes once per day on days -5 to -3
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV over 30 minutes once per day on days -5 to -3
−
*[[Rituximab (Rituxan)]] (for "those with B-cell disease") 375 mg/m2 IV once on days -13, -6, +1, +8
+
*[[Rituximab (Rituxan)]] (for "those with B-cell disease") 375 mg/m<sup>2</sup> IV once on days -13, -6, +1, +8
  
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
Line 1,123: Line 1,209:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
 
*[[Busulfan (Myleran)]] 3.2 mg/kg IV once per day on days -7 to -4
 
*[[Busulfan (Myleran)]] 3.2 mg/kg IV once per day on days -7 to -4
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once on days -3 and -2
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once on days -3 and -2
  
−
Supportive medications:
+
====Supportive medications====
 
*"[[Cyclosporine non-modified (Sandimmune)|Cyclosporine]] alone or cyclosporine plus [[Methotrexate (MTX)|methotrexate]] according to the discretion of the attending physician"
 
*"[[Cyclosporine non-modified (Sandimmune)|Cyclosporine]] alone or cyclosporine plus [[Methotrexate (MTX)|methotrexate]] according to the discretion of the attending physician"
 
*[[Filgrastim (Neupogen)]] 450 mcg SC once per day, starting on day +5 and continued until ANC >3,000
 
*[[Filgrastim (Neupogen)]] 450 mcg SC once per day, starting on day +5 and continued until ANC >3,000
Line 1,158: Line 1,244:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
 
*[[Busulfan (Myleran)]] 3.2 mg/kg IV once per day on days -7 to -4
 
*[[Busulfan (Myleran)]] 3.2 mg/kg IV once per day on days -7 to -4
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -6 to -2
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2
  
−
Supportive medications:
+
====Supportive medications====
 
*"[[Cyclosporine non-modified (Sandimmune)|Cyclosporine]] alone or with [[Methotrexate (MTX)|methotrexate]] according to the discretion of the attending physician"
 
*"[[Cyclosporine non-modified (Sandimmune)|Cyclosporine]] alone or with [[Methotrexate (MTX)|methotrexate]] according to the discretion of the attending physician"
 
*[[Filgrastim (Neupogen)]] 450 mcg SC once per day, starting on day +5 and continued until ANC >3,000
 
*[[Filgrastim (Neupogen)]] 450 mcg SC once per day, starting on day +5 and continued until ANC >3,000
Line 1,180: Line 1,266:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 50 mg/m2 IV once per day on days -6 to -2
+
*[[Fludarabine (Fludara)]] 50 mg/m<sup>2</sup> IV once per day on days -6 to -2
 
*[[Busulfan (Myleran)]] 3.2 mg/kg (ideal body weight) IV once per day over 3 hours on days -5 to -2
 
*[[Busulfan (Myleran)]] 3.2 mg/kg (ideal body weight) IV once per day over 3 hours on days -5 to -2
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Phenytoin (Dilantin)]] "loading" PO/IV, dosed to maintain therapeutic levels of 40 to 80 umol/L on days -5 to -2
 
*[[Phenytoin (Dilantin)]] "loading" PO/IV, dosed to maintain therapeutic levels of 40 to 80 umol/L on days -5 to -2
 
*[[Ciprofloxacin (Cipro)]] 500 mg PO BID as prophylaxis
 
*[[Ciprofloxacin (Cipro)]] 500 mg PO BID as prophylaxis
Line 1,192: Line 1,278:
 
*CMV negative blood
 
*CMV negative blood
  
−
Acute GVHD prophylaxis:
+
====GVHD prophylaxis====
 
*[[Antithymocyte globulin (ATG)|Antithymocyte globulin (Thymoglobulin, rabbit ATG)]] 0.5 mg/kg IV once on day -2; 2 mg/kg/day IV once on days -1 and 0 (total dose of 4.5 mg/kg)
 
*[[Antithymocyte globulin (ATG)|Antithymocyte globulin (Thymoglobulin, rabbit ATG)]] 0.5 mg/kg IV once on day -2; 2 mg/kg/day IV once 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 to 400 umol/L
 
*[[Cyclosporine modified (Neoral)]] or [[Cyclosporine non-modified (Sandimmune)]] PO/IV BID, with doses adjusted to maintain cyclosporine levels of 150 to 400 umol/L
−
*[[Methotrexate (MTX)]] 15 mg/m2 once on day 1; 10 mg/m2 once per day on days 3, 6, 11
+
*[[Methotrexate (MTX)]] 15 mg/m<sup>2</sup> once on day 1; 10 mg/m<sup>2</sup> once per day on days 3, 6, 11
 
*[[Folinic acid (Leucovorin)]] 5 mg started 24 hours after each dose of [[Methotrexate (MTX)]] and continued Q6H until 12 hours before the next dose of [[Methotrexate (MTX)]]
 
*[[Folinic acid (Leucovorin)]] 5 mg started 24 hours after each dose of [[Methotrexate (MTX)]] and continued Q6H until 12 hours before the next dose of [[Methotrexate (MTX)]]
  
Line 1,218: Line 1,304:
  
 
''This was a retrospective study from CIBMTR data; regimen and supportive medication details vary.''
 
''This was a retrospective study from CIBMTR data; regimen and supportive medication details vary.''
 +
====Preparative regimen====
 
*[[Cyclophosphamide (Cytoxan)]]
 
*[[Cyclophosphamide (Cytoxan)]]
 
*Total body irradiation (TBI)
 
*Total body irradiation (TBI)
  
 
===References===
 
===References===
−
# Copelan EA, Hamilton BK, Avalos B, Ahn KW, Bolwell BJ, Zhu X, Aljurf M, van Besien K, Bredeson C, Cahn JY, Costa LJ, de Lima M, Gale RP, Hale GA, Halter J, Hamadani M, Inamoto Y, Kamble RT, Litzow MR, Loren AW, Marks DI, Olavarria E, Roy V, Sabloff M, Savani BN, Seftel M, Schouten HC, Ustun C, Waller EK, Weisdorf DJ, Wirk B, Horowitz MM, Arora M, Szer J, Cortes J, Kalaycio ME, Maziarz RT, Saber W. Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI. Blood. 2013 Dec 5;122(24):3863-70. Epub 2013 Sep 24. [http://bloodjournal.hematologylibrary.org/content/122/24/3863.long link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/24065243 PubMed]
+
# '''Retrospective:''' Copelan EA, Hamilton BK, Avalos B, Ahn KW, Bolwell BJ, Zhu X, Aljurf M, van Besien K, Bredeson C, Cahn JY, Costa LJ, de Lima M, Gale RP, Hale GA, Halter J, Hamadani M, Inamoto Y, Kamble RT, Litzow MR, Loren AW, Marks DI, Olavarria E, Roy V, Sabloff M, Savani BN, Seftel M, Schouten HC, Ustun C, Waller EK, Weisdorf DJ, Wirk B, Horowitz MM, Arora M, Szer J, Cortes J, Kalaycio ME, Maziarz RT, Saber W. Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI. Blood. 2013 Dec 5;122(24):3863-70. Epub 2013 Sep 24. [http://www.bloodjournal.org/content/122/24/3863.long link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/24065243 PubMed]
  
 
==Fludarabine, Busulfan, Cyclophosphamide {{#subobject:84acb0|Regimen=1}}==
 
==Fludarabine, Busulfan, Cyclophosphamide {{#subobject:84acb0|Regimen=1}}==
Line 1,247: Line 1,334:
 
''This is described by the authors as a lymphoma-directed myeloablative conditioning regimen''
 
''This is described by the authors as a lymphoma-directed myeloablative conditioning regimen''
  
−
====Conditioning====
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 25 mg/m2/day IV on days -8 to -4
+
*[[Fludarabine (Fludara)]] 25 mg/m<sup>2</sup>/day IV on days -8 to -4
 
*[[Busulfan (Myleran)]] 4 mg/kg/day PO or 3.2 mg/kg/day IV on days -6 to -4
 
*[[Busulfan (Myleran)]] 4 mg/kg/day PO or 3.2 mg/kg/day IV on days -6 to -4
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg/day IV on days -3 and -2
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg/day IV on days -3 and -2
−
 
−
'''Day 0 is the day of transplantation'''
 
  
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
Line 1,286: Line 1,371:
  
 
''This regimen is meant for related donors; only 8 patients received this regimen before the addition of ATG (rabbit) after 2006.''
 
''This regimen is meant for related donors; only 8 patients received this regimen before the addition of ATG (rabbit) after 2006.''
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV over 30 minutes once per day on days -7 to -3
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV over 30 minutes once per day on days -7 to -3
 
*[[Busulfan (Myleran)]] 0.8 mg/kg IV over 2 hours q6h on days -4 & -3 (8 total doses)
 
*[[Busulfan (Myleran)]] 0.8 mg/kg IV over 2 hours q6h on days -4 & -3 (8 total doses)
  
−
GVHD prophylaxis:
+
====GVHD prophylaxis====
 
*[[Tacrolimus (Prograf)]] with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
 
*[[Tacrolimus (Prograf)]] with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
−
*[[Methotrexate (MTX)]] 5 mg/m2 IV once per day on days +1, +3, +6, +11
+
*[[Methotrexate (MTX)]] 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
  
 
===References===
 
===References===
Line 1,318: Line 1,403:
 
|}
 
|}
 
''Limited details are available in the abstract. Treatment is preceded by [[Acute_myeloid_leukemia#Clofarabine_.26_Cytarabine|clofarabine & cytarabine salvage]] and is meant to be given during aplasia.''
 
''Limited details are available in the abstract. Treatment is preceded by [[Acute_myeloid_leukemia#Clofarabine_.26_Cytarabine|clofarabine & cytarabine salvage]] and is meant to be given during aplasia.''
−
*[[Clofarabine (Clolar)]] 4 x 30 mg/m2 IV
+
====Preparative regimen====
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV
+
*[[Clofarabine (Clolar)]] 4 x 30 mg/m<sup>2</sup> IV
 +
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV
  
 
===References===
 
===References===
Line 1,329: Line 1,415:
  
 
Details to be completed.
 
Details to be completed.
 +
====Preparative regimen====
 
*[[Cyclophosphamide (Cytoxan)]]
 
*[[Cyclophosphamide (Cytoxan)]]
 
*[[Fludarabine (Fludara)]]
 
*[[Fludarabine (Fludara)]]
Line 1,360: Line 1,447:
  
 
====Preparative regimen====
 
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -5 to -3
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -5 to -3
−
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m2 IV once per day on days -5 to -3
+
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once per day on days -5 to -3
 
*[[Rituximab (Rituxan)]] as follows:
 
*[[Rituximab (Rituxan)]] as follows:
−
**375 mg/m2 IV once on day -13
+
**375 mg/m<sup>2</sup> IV once on day -13
−
**1000 mg/m2 IV once per day on days -6, +1, +8
+
**1000 mg/m<sup>2</sup> IV once per day on days -6, +1, +8
  
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 
*[[Tacrolimus (Prograf)]] adjusted to level of 5 to 10 ng/mL for 6 months in patients in remission
 
*[[Tacrolimus (Prograf)]] adjusted to level of 5 to 10 ng/mL for 6 months in patients in remission
 
*[[Methotrexate (MTX)]] as follows:
 
*[[Methotrexate (MTX)]] as follows:
−
**Related donors: 5 mg/m2 IV once per day on days +1, +3, +6
+
**Related donors: 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6
−
**Unrelated donors: 5 mg/m2 IV once per day on days +1, +3, +6, +11
+
**Unrelated donors: 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
 
*[[Antithymocyte globulin, horse ATG (Atgam)]] as follows:
 
*[[Antithymocyte globulin, horse ATG (Atgam)]] as follows:
 
**Matched unrelated donor: 15 mg/kg IV once per day on days -5 to -3
 
**Matched unrelated donor: 15 mg/kg IV once per day on days -5 to -3
Line 1,421: Line 1,508:
 
''Details are best described in Maris et al. 2003.''
 
''Details are best described in Maris et al. 2003.''
 
====Preparative regimen====
 
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -4 to -2
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -4 to -2
 
*Total body irradiation (TBI) 2 Gy at a rate of 0.07 Gy/min on day 0
 
*Total body irradiation (TBI) 2 Gy at a rate of 0.07 Gy/min on day 0
  
Line 1,460: Line 1,547:
  
 
''This regimen is meant for all types of donors.''
 
''This regimen is meant for all types of donors.''
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV over 30 minutes once per day on days -7 to -3
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV over 30 minutes once per day on days -7 to -3
 
*[[Busulfan (Myleran)]] 0.8 mg/kg IV over 2 hours q6h on days -4 & -3 (8 total doses)
 
*[[Busulfan (Myleran)]] 0.8 mg/kg IV over 2 hours q6h on days -4 & -3 (8 total doses)
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)|ATG (Rabbit)]] 2.5 mg/kg IV over 6 hours once per day on days -4 to -2
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)|ATG (Rabbit)]] 2.5 mg/kg IV over 6 hours once per day on days -4 to -2
  
−
GVHD prophylaxis:
+
====GVHD prophylaxis====
 
*[[Tacrolimus (Prograf)]] with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
 
*[[Tacrolimus (Prograf)]] with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
−
*[[Methotrexate (MTX)]] 5 mg/m2 IV once per day on days +1, +3, +6, +11
+
*[[Methotrexate (MTX)]] 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
  
 
===Regimen #2 {{#subobject:e2c4bf|Variant=1}}===
 
===Regimen #2 {{#subobject:e2c4bf|Variant=1}}===
Line 1,483: Line 1,570:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -10 to -5 (6 consecutive days)
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -10 to -5 (6 consecutive days)
 
*[[Busulfan (Myleran)]] 4 mg/kg/day PO on days -6 to -5 (2 consecutive days)
 
*[[Busulfan (Myleran)]] 4 mg/kg/day PO on days -6 to -5 (2 consecutive days)
 
*[[Antithymocyte globulin (ATG)]] (ATG-Fresenius) 10 mg/kg/day on days -4 to -1 (4 consecutive days)
 
*[[Antithymocyte globulin (ATG)]] (ATG-Fresenius) 10 mg/kg/day on days -4 to -1 (4 consecutive days)
Line 1,502: Line 1,589:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2/day (route not specified) on days -6 to -2 (5 consecutive days)
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup>/day (route not specified) on days -6 to -2 (5 consecutive days)
−
*[[Busulfan (Myleran)]] 130 mg/m2 IV over 3 hours once per day on days -5 to -3 (3 consecutive days)
+
*[[Busulfan (Myleran)]] 130 mg/m<sup>2</sup> IV over 3 hours once per day on days -5 to -3 (3 consecutive days)
 
*[[Antithymocyte globulin (ATG)]] (subtype not specified) 2.5 mg/kg/day IV on days -2 & -1
 
*[[Antithymocyte globulin (ATG)]] (subtype not specified) 2.5 mg/kg/day IV on days -2 & -1
  
Line 1,535: Line 1,622:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
''Day 0 is the day of transplantation.''
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2
−
 
 
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -6 to -2
 
 
*[[Busulfan (Myleran)]] 3.2 mg/kg/day (route not specified) on days -5 & -4
 
*[[Busulfan (Myleran)]] 3.2 mg/kg/day (route not specified) on days -5 & -4
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2.5 mg/kg IV once on day -1
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2.5 mg/kg IV once on day -1
−
*[[Rituximab (Rituxan)]] 250 mg/m2 IV once per day on days -21 & -14
+
*[[Rituximab (Rituxan)]] 250 mg/m<sup>2</sup> IV once per day on days -21 & -14
 
*[[Ibritumomab tiuxetan (Zevalin)]] 0.4 mCi/kg (maximum dose of 32 mCi) IV once on day -14
 
*[[Ibritumomab tiuxetan (Zevalin)]] 0.4 mCi/kg (maximum dose of 32 mCi) IV once on day -14
  
−
GVHD prophylaxis:
+
====GVHD prophylaxis====
 
*Cyclosporine (type and dose not specified) until day +90 and tapered off by day +180 based on chimerism and GVHD
 
*Cyclosporine (type and dose not specified) until day +90 and tapered off by day +180 based on chimerism and GVHD
 
*[[Methotrexate (MTX)]] as follows (for unrelated donors with HLA mismatch):
 
*[[Methotrexate (MTX)]] as follows (for unrelated donors with HLA mismatch):
−
**15 mg/m2 (route not specified) once on day +1
+
**15 mg/m<sup>2</sup> (route not specified) once on day +1
−
**10 mg/m2 (route not specified) once per day on days +3 & +6
+
**10 mg/m<sup>2</sup> (route not specified) once per day on days +3 & +6
  
 
===References===
 
===References===
Line 1,575: Line 1,660:
  
 
''This regimen is intended for related donors.''
 
''This regimen is intended for related donors.''
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -6 to -2
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2
−
*[[Cyclophosphamide (Cytoxan)]] 500 mg/m2 IV once per day on days -6 to -2
+
*[[Cyclophosphamide (Cytoxan)]] 500 mg/m<sup>2</sup> IV once per day on days -6 to -2
  
 
===References===
 
===References===
Line 1,606: Line 1,691:
  
 
''This regimen is intended for unrelated donors.''
 
''This regimen is intended for unrelated donors.''
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -6 to -2 (5 consecutive days)
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2 (5 consecutive days)
−
*[[Cyclophosphamide (Cytoxan)]] 500 mg/m2 IV once per day on days -6 to -2 (5 consecutive days)
+
*[[Cyclophosphamide (Cytoxan)]] 500 mg/m<sup>2</sup> IV once per day on days -6 to -2 (5 consecutive days)
 
*[[Antithymocyte globulin (ATG)]] (ATG-Fresenius) 10 mg/kg/day on days -4 to -1 (4 consecutive days)
 
*[[Antithymocyte globulin (ATG)]] (ATG-Fresenius) 10 mg/kg/day on days -4 to -1 (4 consecutive days)
  
Line 1,628: Line 1,713:
 
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 
|-
 
|-
−
|[http://bloodjournal.hematologylibrary.org/content/118/2/282.long Brunstein et al. 2011]
+
|[http://www.bloodjournal.org/content/118/2/282.long Brunstein et al. 2011]
 
|<span  
 
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
Line 1,637: Line 1,722:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 40 mg/m2 IV once per day on days -6 to -2 (5 consecutive days)
+
*[[Fludarabine (Fludara)]] 40 mg/m<sup>2</sup> IV once per day on days -6 to -2 (5 consecutive days)
 
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IV once on day -6
 
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IV once on day -6
 
*Total body irradiation (TBI) 2 Gy once on day -1
 
*Total body irradiation (TBI) 2 Gy once on day -1
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Mesna (Mesnex)]] (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
 
*[[Mesna (Mesnex)]] (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
 
*[[Filgrastim (Neupogen)]] 5 µg/kg SC once per day, starting on day +1, continued until ANC =2000/µL for 3 consecutive days
 
*[[Filgrastim (Neupogen)]] 5 µg/kg SC once per day, starting on day +1, continued until ANC =2000/µL for 3 consecutive days
Line 1,649: Line 1,734:
 
*[[Mycophenolate mofetil (CellCept)]] 1000 mg (route not specified) Q8H for patients >50 kg, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
 
*[[Mycophenolate mofetil (CellCept)]] 1000 mg (route not specified) Q8H for patients >50 kg, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
 
**Patients <50 kg received [[Mycophenolate mofetil (CellCept)]] 15 mg/kg (route not specified) Q8H, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
 
**Patients <50 kg received [[Mycophenolate mofetil (CellCept)]] 15 mg/kg (route not specified) Q8H, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
−
*[[Cyclosporine modified (Neoral)|Cyclosporine A]] ([[Cyclosporine modified (Neoral)|Neoral]] vs. [[Cyclosporine non-modified (Sandimmune)|Sandimmune]] not specified, route not specified) with a goal trough of 200 to 400 ng/mL (starting date not specified) until day +100. Patients without GVHD had their dose tapered by 10% each week starting on day +101, with discontinuation of cyclosporine A around day +180 to +200.  
+
*[[Cyclosporine modified (Neoral)|Cyclosporine A]] ([[Cyclosporine modified (Neoral)|Neoral]] vs. [[Cyclosporine non-modified (Sandimmune)|Sandimmune]] not specified, route not specified) with a goal trough of 200 to 400 ng/mL (starting date not specified) until day +100. Patients without GVHD had their dose tapered by 10% each week starting on day +101, with discontinuation of cyclosporine A around day +180 to +200.  
 
*[[Tacrolimus (Prograf)]] (route not specified) with a goal trough level of 5 to 10 ng/mL could be substituted for cyclosporine.
 
*[[Tacrolimus (Prograf)]] (route not specified) with a goal trough level of 5 to 10 ng/mL could be substituted for cyclosporine.
  
Line 1,657: Line 1,742:
 
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 
|-
 
|-
−
|[http://bloodjournal.hematologylibrary.org/content/118/2/282.long Brunstein et al. 2011]
+
|[http://www.bloodjournal.org/content/118/2/282.long Brunstein et al. 2011]
 
|<span  
 
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
Line 1,666: Line 1,751:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -6 to -2 (5 consecutive days)
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2 (5 consecutive days)
 
*[[Cyclophosphamide (Cytoxan)]] 14.5 mg/kg IV once on days -6 and -5 (2 consecutive days)
 
*[[Cyclophosphamide (Cytoxan)]] 14.5 mg/kg IV once on days -6 and -5 (2 consecutive days)
 
*Total body irradiation (TBI) 2 Gy once on day -1
 
*Total body irradiation (TBI) 2 Gy once on day -1
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Mesna (Mesnex)]] (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
 
*[[Mesna (Mesnex)]] (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
 
*[[Filgrastim (Neupogen)]] 5 µg/kg SC once per day, starting on day +5, continued until ANC =1000/µL for 3 consecutive days
 
*[[Filgrastim (Neupogen)]] 5 µg/kg SC once per day, starting on day +5, continued until ANC =1000/µL for 3 consecutive days
Line 1,681: Line 1,766:
  
 
===References===
 
===References===
−
# Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J, Devine SM, Wingard JR, Aljitawi OS, Cutler CS, Jagasia MH, Ballen KK, Eapen M, O'Donnell PV;Blood and Marrow Transplant Clinical Trials Network. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood. 2011 Jul 14;118(2):282-8. [http://bloodjournal.hematologylibrary.org/content/118/2/282.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21527516 PubMed]
+
# Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J, Devine SM, Wingard JR, Aljitawi OS, Cutler CS, Jagasia MH, Ballen KK, Eapen M, O'Donnell PV;Blood and Marrow Transplant Clinical Trials Network. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood. 2011 Jul 14;118(2):282-8. [http://www.bloodjournal.org/content/118/2/282.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21527516 PubMed]
  
 
==Fludarabine & Melphalan==
 
==Fludarabine & Melphalan==
Line 1,702: Line 1,787:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 150 mg/m2 IV once per day on days -8 to -4
+
*[[Fludarabine (Fludara)]] 150 mg/m<sup>2</sup> IV once per day on days -8 to -4
−
*[[Melphalan (Alkeran)]] 140 mg/m2 IV once per day on days -3 & -2
+
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once per day on days -3 & -2
  
 
Recipients of stem cells from matched unrelated donors also received:
 
Recipients of stem cells from matched unrelated donors also received:
 
*[[Antithymocyte globulin (ATG)]] 45 mg/kg IV once per day on days -4 to -2
 
*[[Antithymocyte globulin (ATG)]] 45 mg/kg IV once per day on days -4 to -2
  
−
====Graft-versus-host disease prophylaxis====
+
====GVHD prophylaxis====
 
*Cyclosporine A (not specified whether modified or non-modified) starting at 1.5 mg/kg BID IV on day -2  
 
*Cyclosporine A (not specified whether modified or non-modified) starting at 1.5 mg/kg BID IV on day -2  
−
*[[Methotrexate (MTX)]] 10 mg/m2 IV once per day on days +1, +3, +6 and +11
+
*[[Methotrexate (MTX)]] 10 mg/m<sup>2</sup> IV once per day on days +1, +3, +6 and +11
  
 
''If no acute GVHD of grade 2 or more, cyclosporine A is tapered down by 10% per week starting on day +90 with planned discontinuation by day +180.''
 
''If no acute GVHD of grade 2 or more, cyclosporine A is tapered down by 10% per week starting on day +90 with planned discontinuation by day +180.''
Line 1,729: Line 1,814:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Preparative regimen====
−
*[[Fludarabine (Fludara)]] 33 mg/m2 IV once per day on days -5 to -2
+
*[[Fludarabine (Fludara)]] 33 mg/m<sup>2</sup> IV once per day on days -5 to -2
−
*[[Melphalan (Alkeran)]] 70 mg/m2 IV once per day on days -3 & -2
+
*[[Melphalan (Alkeran)]] 70 mg/m<sup>2</sup> IV once per day on days -3 & -2
  
 
Recipients of stem cells from matched unrelated donors also received:
 
Recipients of stem cells from matched unrelated donors also received:
 
*[[Antithymocyte globulin (ATG)]] 2 mg/kg IV once per day on days -4 to -2
 
*[[Antithymocyte globulin (ATG)]] 2 mg/kg IV once per day on days -4 to -2
  
−
====Graft-versus-host disease prophylaxis====
+
====GVHD prophylaxis====
 
*[[Tacrolimus (Prograf)]] IV starting on day -2, dosed to achieve serum levels 4–12 ng/mL and switched to PO as soon as possible. Continued for at least 6 months and then "tapered off" (instructions not given).
 
*[[Tacrolimus (Prograf)]] IV starting on day -2, dosed to achieve serum levels 4–12 ng/mL and switched to PO as soon as possible. Continued for at least 6 months and then "tapered off" (instructions not given).
−
*[[Methotrexate (MTX)]] 5 mg/m2 IV once per day on days +1, +3, +6 (extra dose on day +11 for MUD recipients)
+
*[[Methotrexate (MTX)]] 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6 (extra dose on day +11 for MUD recipients)
  
 
===References===
 
===References===
Line 1,799: Line 1,884:
 
|}
 
|}
 
====Preparative regimen====
 
====Preparative regimen====
−
*[[Rituximab (Rituxan)]] 250 mg/m2 IV once per day on days -14 & -7
+
*[[Rituximab (Rituxan)]] 250 mg/m<sup>2</sup> IV once per day on days -14 & -7
 
*[[Ibritumomab tiuxetan (Zevalin)|Ibritumomab tiuxetan & Indium-111 5 mCi]] IV once on day -14 for dosimetry
 
*[[Ibritumomab tiuxetan (Zevalin)|Ibritumomab tiuxetan & Indium-111 5 mCi]] IV once on day -14 for dosimetry
 
*[[Ibritumomab tiuxetan (Zevalin)|Ibritumomab tiuxetan & Yttrium-90 (Zevalin) ]] 0.4 mCi/kg (15 MBq/kg) (maximum dose of 32 mCi/1.2 GBq) IV once on day -7
 
*[[Ibritumomab tiuxetan (Zevalin)|Ibritumomab tiuxetan & Yttrium-90 (Zevalin) ]] 0.4 mCi/kg (15 MBq/kg) (maximum dose of 32 mCi/1.2 GBq) IV once on day -7
−
*[[Fludarabine (Fludara)]] 30 mg/m2 IV once per day on days -5 to -3
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -5 to -3
−
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m2 IV once per day on days -5 to -3
+
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once per day on days -5 to -3
  
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
Line 1,823: Line 1,908:
 
|}
 
|}
  
−
===Regimen {{#subobject:pyv1|Variant=1}}===
+
===Regimen {{#subobject:pyv1|Variant=1}}===
 
{| border="1" style="text-align:center;" !align="left"  
 
{| border="1" style="text-align:center;" !align="left"  
 
|'''Study'''
 
|'''Study'''
Line 1,839: Line 1,924:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Regimen details====
 
*[[Defibrotide (Defitelio)]] 6.25 mg/kg IV over 2 hours once every 6 hours  
 
*[[Defibrotide (Defitelio)]] 6.25 mg/kg IV over 2 hours once every 6 hours  
−
'''given for at least 21 days.''' If after 21 days signs and symptoms of VOD have not resolved, give until VOD is resolved, up to a maximum of 60 days.
+
'''Given for at least 21 days.''' If after 21 days signs and symptoms of VOD have not resolved, give until VOD is resolved, up to a maximum of 60 days.
  
 
===References===
 
===References===
 
# Richardson PG, Riches ML, Kernan NA, Brochstein JA, Mineishi S, Termuhlen AM, Arai S, Grupp SA, Guinan EC, Martin PL, Steinbach G, Krishnan A, Nemecek ER, Giralt S, Rodriguez T, Duerst R, Doyle J, Antin JH, Smith A, Lehmann L, Champlin R, Gillio A, Bajwa R, D'Agostino RB Sr, Massaro J, Warren D, Miloslavsky M, Hume RL, Iacobelli M, Nejadnik B, Hannah AL, Soiffer RJ. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood. 2016 Jan 29. [http://www.bloodjournal.org/content/early/2016/01/29/blood-2015-10-676924.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/26825712 PubMed]
 
# Richardson PG, Riches ML, Kernan NA, Brochstein JA, Mineishi S, Termuhlen AM, Arai S, Grupp SA, Guinan EC, Martin PL, Steinbach G, Krishnan A, Nemecek ER, Giralt S, Rodriguez T, Duerst R, Doyle J, Antin JH, Smith A, Lehmann L, Champlin R, Gillio A, Bajwa R, D'Agostino RB Sr, Massaro J, Warren D, Miloslavsky M, Hume RL, Iacobelli M, Nejadnik B, Hannah AL, Soiffer RJ. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood. 2016 Jan 29. [http://www.bloodjournal.org/content/early/2016/01/29/blood-2015-10-676924.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/26825712 PubMed]
 +
 +
[[Category:Chemotherapy regimens]]
 +
[[Category:Transplant regimens]]

Revision as of 00:56, 21 August 2016

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.

Unlike the other chemotherapy regimen pages, this one is not disease-specific. Rather, this is a gathering point for all transplant mobilization & conditioning regimens, the latter of which will eventually also be available under their respective disease-specific pages. However, this page will remain as a central reference for these types of regimens. Unless otherwise specified, the day of hematopoietic cell re-infusion is by convention day 0.

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Stem cell mobilization

These are regimens intended to mobilize stem cells, very incomplete right now but will be filled in over time.

Cyclophosphamide & G-CSF

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Regimen

Study Evidence
Royer et al. 2016 Phase II

Mobilization regimen

References

  1. Royer B, Minvielle S, Diouf M, Roussel M, Karlin L, Hulin C, Arnulf B, Macro M, Cailleres S, Brion A, Brechignac S, Belhadj K, Chretien ML, Wetterwald M, Chaleteix C, Tiab M, Leleu X, Frenzel L, Garderet L, Choquet S, Fuzibet JG, Dauriac C, Forneker LM, Benboubker L, Facon T, Moreau P, Avet-Loiseau H, Marolleau JP. Bortezomib, Doxorubicin, Cyclophosphamide, Dexamethasone Induction Followed by Stem Cell Transplantation for Primary Plasma Cell Leukemia: A Prospective Phase II Study of the Intergroupe Francophone du Myélome. J Clin Oncol. 2016 Jun 20;34(18):2125-32. Epub 2016 Apr 25. link to original article contains protocol PubMed

Cytarabine & G-CSF

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Regimen

Study Evidence
Abrey et al. 2003 Phase II

Mobilization regimen

References

  1. Abrey LE, Moskowitz CH, Mason WP, Crump M, Stewart D, Forsyth P, Paleologos N, Correa DD, Anderson ND, Caron D, Zelenetz A, Nimer SD, DeAngelis LM. Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: an intent-to-treat analysis. J Clin Oncol. 2003 Nov 15;21(22):4151-6. link to original article contains verified protocol PubMed

Cytarabine, Ifosfamide, G-CSF

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Regimen

Study Evidence
Colombat et al. 2006 Phase II

Mobilization regimen

References

  1. Colombat P, Lemevel A, Bertrand P, Delwail V, Rachieru P, Brion A, Berthou C, Bay JO, Delepine R, Desablens B, Camilleri-Broët S, Linassier C, Lamy T. High-dose chemotherapy with autologous stem cell transplantation as first-line therapy for primary CNS lymphoma in patients younger than 60 years: a multicenter phase II study of the GOELAMS group. Bone Marrow Transplant. 2006 Sep;38(6):417-20. link to original article contains verified protocol PubMed

CYVE & G-CSF

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CYVE: CYtarabine, VEpesid (Etoposide)

Regimen

Study Evidence
Soussain et al. 2001 Pilot, >20 pts
Soussain et al. 2008 Phase II

Target collection dose not described; mobilization took place after the first course of CYVE salvage for CNS lymphoma.

Mobilization regimen

  • Cytarabine (Cytosar) as follows:
    • 2000 mg/m2 IV over 3 hours once per day on days 2 to 5
    • 50 mg/m2 IV over 12 hours once per day on days 1 to 5
  • Etoposide (Vepesid) 200 mg/m2 IV over 2 hours once per day on days 2 to 5
  • Filgrastim (Neupogen) 5 μg/kg SC once per day starting 48 hours after end of chemotherapy

References

  1. Soussain C, Suzan F, Hoang-Xuan K, Cassoux N, Levy V, Azar N, Belanger C, Achour E, Ribrag V, Gerber S, Delattre JY, Leblond V. Results of intensive chemotherapy followed by hematopoietic stem-cell rescue in 22 patients with refractory or recurrent primary CNS lymphoma or intraocular lymphoma. J Clin Oncol. 2001 Feb 1;19(3):742-9. link to original article contains verified protocol PubMed
  2. Soussain C, Hoang-Xuan K, Taillandier L, Fourme E, Choquet S, Witz F, Casasnovas O, Dupriez B, Souleau B, Taksin AL, Gisselbrecht C, Jaccard A, Omuro A, Sanson M, Janvier M, Kolb B, Zini JM, Leblond V; Société Française de Greffe de Moëlle Osseuse-Thérapie Cellulaire. Intensive chemotherapy followed by hematopoietic stem-cell rescue for refractory and recurrent primary CNS and intraocular lymphoma: Société Française de Greffe de Moëlle Osseuse-Thérapie Cellulaire. J Clin Oncol. 2008 May 20;26(15):2512-8. Epub 2008 Apr 14. link to original article contains verified protocol PubMed

IGEV & Lenograstim

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IGEV: Ifosfamide, GEmcitabine, Vinorelbine

Regimen

Study Evidence
Magagnoli et al. 2007 Phase II

Mobilization regimen

Supportive medications

Apheresis was performed when the peripheral blood CD34+ cell count exceeded 10 cells/µl.

References

  1. Magagnoli M, Spina M, Balzarotti M, Timofeeva I, Isa L, Michieli M, Capizzuto R, Morenghi E, Castagna L, Tirelli U, Santoro A. IGEV regimen and a fixed dose of lenograstim: an effective mobilization regimen in pretreated Hodgkin's lymphoma patients. Bone Marrow Transplant. 2007 Dec;40(11):1019-25. Epub 2007 Oct 1. link to original article contains verified protocol PubMed

Autologous stem cell transplant

BCNU/TT

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BCNU/TT: BCNU (Carmustine), ThioTepa

Regimen #1

Study Evidence
Illerhaus et al. 2006 Phase II

Preparative regimen

Supportive medications

Stem cells re-infused on day 56

Regimen #2

Study Evidence
Illerhaus et al. 2008 Pilot, <20 patients

Preparative regimen

Stem cells re-infused on day 7

References

  1. Illerhaus G, Marks R, Ihorst G, Guttenberger R, Ostertag C, Derigs G, Frickhofen N, Feuerhake F, Volk B, Finke J. High-dose chemotherapy with autologous stem-cell transplantation and hyperfractionated radiotherapy as first-line treatment of primary CNS lymphoma. J Clin Oncol. 2006 Aug 20;24(24):3865-70. Epub 2006 Jul 24. link to original article contains verified protocol PubMed
  2. Illerhaus G, Müller F, Feuerhake F, Schäfer AO, Ostertag C, Finke J. High-dose chemotherapy and autologous stem-cell transplantation without consolidating radiotherapy as first-line treatment for primary lymphoma of the central nervous system. Haematologica. 2008 Jan;93(1):147-8. link to original article contains verified protocol PubMed

BEAC

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BEAC: BiCNU (Carmustine), Etoposide, Ara-C (Cytarabine), Cyclophosphamide

Regimen

Study Evidence Comparator
Philip et al. 1995 (PARMA) Phase III DHAP x 4

Treatment in PARMA preceded by DHAP x 2.

Preparative regimen

Supportive medications

  • Filgrastim (Neupogen) 5 mcg/kg SC once per day 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

  1. Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, Sonneveld P, Gisselbrecht C, Cahn JY, Harousseau JL, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. N Engl J Med. 1995 Dec 7;333(23):1540-5. link to original article PubMed
  2. Retrospective: 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. link to original article contains protocol PubMed

BEAM

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BEAM: BiCNU (Carmustine), Etoposide, Ara-C (Cytarabine), Melphalan

Regimen #1

Study Evidence Comparator
Shimoni et al. 2012 Randomized Phase II Z-BEAM

Preparative regimen

Supportive medications

Regimen #2

Study Evidence
Gisselbrecht et al. 2010 Non-randomized

Preparative regimen

Regimen #3

Study Evidence
Abrey et al. 2003 Phase II
Stewart et al. 2006 Phase II

Preparative regimen

Supportive medications

While ANC <500:

Regimen #4

Study Evidence
Colombat et al. 2006 Phase II

Preparative regimen

Day of transplant is not specified

Regimen #5

Study Evidence
Josting et al. 2005 Phase II

Paper did not specify which day peripheral blood stem cells were administered.

Preparative regimen

Regimen #6

Study Evidence
Jo et al. 2008 Retrospective

Preparative regimen

Supportive medications

  • Filgrastim (Neupogen) 5 mcg/kg SC once per day 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 #7

Study Evidence
Zinzani et al. 2003 Retrospective

Preparative regimen

References

  1. Retrospective: Zinzani PL, Tani M, Gabriele A, Gherlinzoni F, de Vivo A, Ricci P, Bandini G, Lemoli RM, Motta MR, Rizzi S, Giudice V, Zompatori M, Stefoni V, Alinari L, Musuraca G, Bassi S, Conte R, Pileri S, Tura S, Baccarani M. High-dose therapy with autologous transplantation for Hodgkin's disease: the Bologna experience. Haematologica. 2003 May;88(5):522-8. link to original article contains verified protocol PubMed
  2. Abrey LE, Moskowitz CH, Mason WP, Crump M, Stewart D, Forsyth P, Paleologos N, Correa DD, Anderson ND, Caron D, Zelenetz A, Nimer SD, DeAngelis LM. Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: an intent-to-treat analysis. J Clin Oncol. 2003 Nov 15;21(22):4151-6. link to original article contains verified protocol PubMed
  3. Zinzani PL, Tani M, Gabriele A, Gherlinzoni F, De Vivo A, Ricci P, Bandini G, Lemoli RM, Motta MR, Rizzi S, Guidice V, Zompatori M, Stefoni V, Alinari L, Musuraca G, Marchi E, Bassi S, Conte R, Pileri S, Tura S, Baccarani M. High-dose therapy with autologous transplantation for aggressive non-Hodgkin's lymphoma: the Bologna experience. Leuk Lymphoma. 2004 Feb;45(2):321-6. PubMed
  4. 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. link to original article contains protocol PubMed
  5. 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. link to original article contains protocol PubMed content property of HemOnc.org
  6. Colombat P, Lemevel A, Bertrand P, Delwail V, Rachieru P, Brion A, Berthou C, Bay JO, Delepine R, Desablens B, Camilleri-Broët S, Linassier C, Lamy T. High-dose chemotherapy with autologous stem cell transplantation as first-line therapy for primary CNS lymphoma in patients younger than 60 years: a multicenter phase II study of the GOELAMS group. Bone Marrow Transplant. 2006 Sep;38(6):417-20. link to original article contains verified protocol PubMed
  7. Retrospective: 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. link to original article contains protocol PubMed
  8. 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. Epub 2010 Jul 26. Erratum in: J Clin Oncol. 2012 May 20;30(15):1896. link to original article contains verified protocol PubMed
  9. Shimoni A, Avivi I, Rowe JM, Yeshurun M, Levi I, Or R, Patachenko P, Avigdor A, Zwas T, Nagler A. A randomized study comparing yttrium-90 ibritumomab tiuxetan (Zevalin) and high-dose BEAM chemotherapy versus BEAM alone as the conditioning regimen before autologous stem cell transplantation in patients with aggressive lymphoma. Cancer. 2012 Oct 1;118(19):4706-14. Epub 2012 Jan 17. link to original article contains verified protocol PubMed
  10. Pardal E, Coronado M, Martín A, Grande C, Marín-Niebla A, Panizo C, Bello JL, Conde E, Hernández MT, Arranz R, Bargay J, González-Barca E, Pérez-Ceballos E, Montes-Moreno S, Caballero MD. Intensification treatment based on early FDG-PET in patients with high-risk diffuse large B-cell lymphoma: a phase II GELTAMO trial. Br J Haematol. 2014 Nov;167(3):327-36. Epub 2014 Jul 28. link to original article contains verified protocol PubMed

BeEAM

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BeEAM: Bendamustine, Etoposide, Ara-C (Cytarabine), Melphalan

Regimen

Study Evidence
Visani et al. 2011 Phase II

To be completed

References

  1. Visani G, Malerba L, Stefani PM, Capria S, Galieni P, Gaudio F, Specchia G, Meloni G, Gherlinzoni F, Giardini C, Falcioni S, Cuberli F, Gobbi M, Sarina B, Santoro A, Ferrara F, Rocchi M, Ocio EM, Caballero MD, Isidori A. BeEAM (bendamustine, etoposide, cytarabine, melphalan) before autologous stem cell transplantation is safe and effective for resistant/relapsed lymphoma patients. Blood. 2011 Sep 22;118(12):3419-25. Epub 2011 Aug 3. link to original article PubMed

Bor-HDM

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Bor-HDM: Bortezomib, High Dose Melphalan

Regimen

Study Evidence
Roussel et al. 2009 Phase II

Autologous hematopoetic stem cell transplant on day 0.

Preparative regimen

Supportive medications

  • "All patients received standard supportive care measures"

References

  1. Roussel M, Moreau P, Huynh A, Mary JY, Danho C, Caillot D, Hulin C, Fruchart C, Marit G, Pégourié B, Lenain P, Araujo C, Kolb B, Randriamalala E, Royer B, Stoppa AM, Dib M, Dorvaux V, Garderet L, Mathiot C, Avet-Loiseau H, Harousseau JL, Attal M; Intergroupe Francophone du Myélome (IFM). Bortezomib and high-dose melphalan as conditioning regimen before autologous stem cell transplantation in patients with de novo multiple myeloma: a phase 2 study of the Intergroupe Francophone du Myelome (IFM). Blood. 2010 Jan 7;115(1):32-7. Epub 2009 Nov 2. link to original article contains verified protocol PubMed

Busulfan & Melphalan

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Regimen

Study Evidence
Yanada et al. 2013 Phase II

Preparative regimen

References

  1. Yanada M, Tsuzuki M, Fujita H, Fujimaki K, Fujisawa S, Sunami K, Taniwaki M, Ohwada A, Tsuboi K, Maeda A, Takeshita A, Ohtake S, Miyazaki Y, Atsuta Y, Kobayashi Y, Naoe T, Emi N; Japan Adult Leukemia Study Group. Phase 2 study of arsenic trioxide followed by autologous hematopoietic cell transplantation for relapsed acute promyelocytic leukemia. Blood. 2013 Apr 18;121(16):3095-102. Epub 2013 Feb 14. link to original article Contains verified protocol PubMed

Bu/TT

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Bu/TT: Busulfan, ThioTepa

Regimen

Study Evidence
Montemurro et al. 2007 (OSHO-53) Phase II

Preparative regimen

References

  1. Montemurro M, Kiefer T, Schüler F, Al-Ali HK, Wolf HH, Herbst R, Haas A, Helke K, Theilig A, Lotze C, Hirt C, Niederwieser D, Schwenke M, Krüger WH, Dölken G. Primary central nervous system lymphoma treated with high-dose methotrexate, high-dose busulfan/thiotepa, autologous stem-cell transplantation and response-adapted whole-brain radiotherapy: results of the multicenter Ostdeutsche Studiengruppe Hamato-Onkologie OSHO-53 phase II study. Ann Oncol. 2007 Apr;18(4):665-71. Epub 2006 Dec 21. link to original article contains verified protocol PubMed

Bu/TT/Cy

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Bu/TT/Cy: Busulfan, ThioTepa, Cyclophosphamide

Regimen

Study Evidence
Omuro et al. 2015 Phase II

Preparative regimen

References

  1. Omuro A, Correa DD, DeAngelis LM, Moskowitz CH, Matasar MJ, Kaley TJ, Gavrilovic IT, Nolan C, Pentsova E, Grommes CC, Panageas KS, Baser RE, Faivre G, Abrey LE, Sauter CS. R-MPV followed by high-dose chemotherapy with TBC and autologous stem-cell transplant for newly diagnosed primary CNS lymphoma. Blood. 2015 Feb 26;125(9):1403-10. Epub 2015 Jan 7. link to original article contains verified protocol PubMed

C-VAMP -> high-dose Melphalan (Alkeran)

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C-VAMP: Cyclophosphamide, Vincristine, Adriamycin (Doxorubicin), MethylPrednisolone

Regimen - multiple myeloma high-dose therapy

Study Evidence Comparator
Child et al. 2003 (MRC Myeloma VII) Phase III ABCM

C-VAMP portion

21-day cycles, given until maximal response was achieved. A minimum of 3 cycles given before stem cell harvest.

Preparative regimen

An alternative to the above melphalan option was:

Interferon alfa maintenance therapy

References

  1. 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. link to original article contains verified protocol PubMed

CBV

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CBV: Cyclophosphamide, BiCNU, VP-16

Regimen #1

Study Evidence
Stiff et al. 1998 Phase II
Damon et al. 2009 (CALGB 59909) Phase II

Preparative regimen

Supportive medications

Regimen #2, "CVB"

Study Evidence
Zinzani et al. 2003 Retrospective

Preparative regimen

References

  1. Reece DE, Connors JM, Spinelli JJ, Barnett MJ, Fairey RN, Klingemann HG, Nantel SH, O'Reilly S, Shepherd JD, Sutherland HJ, et al. Intensive therapy with cyclophosphamide, carmustine, etoposide +/- cisplatin, and autologous bone marrow transplantation for Hodgkin's disease in first relapse after combination chemotherapy. Blood. 1994 Mar 1;83(5):1193-9. link to original article PubMed
  2. Stiff PJ, Dahlberg S, Forman SJ, McCall AR, Horning SJ, Nademanee AP, Blume KG, LeBlanc M, Fisher RI. Autologous bone marrow transplantation for patients with relapsed or refractory diffuse aggressive non-Hodgkin's lymphoma: value of augmented preparative regimens--a Southwest Oncology Group trial. J Clin Oncol. 1998 Jan;16(1):48-55. link to original article contains verified protocol PubMed
  3. Retrospective: Zinzani PL, Tani M, Gabriele A, Gherlinzoni F, de Vivo A, Ricci P, Bandini G, Lemoli RM, Motta MR, Rizzi S, Giudice V, Zompatori M, Stefoni V, Alinari L, Musuraca G, Bassi S, Conte R, Pileri S, Tura S, Baccarani M. High-dose therapy with autologous transplantation for Hodgkin's disease: the Bologna experience. Haematologica. 2003 May;88(5):522-8. link to original article contains verified protocol PubMed
  4. Damon LE, Johnson JL, Niedzwiecki D, Cheson BD, Hurd DD, Bartlett NL, Lacasce AS, Blum KA, Byrd JC, Kelly M, Stock W, Linker CA, Canellos GP. Immunochemotherapy and autologous stem-cell transplantation for untreated patients with mantle-cell lymphoma: CALGB 59909. J Clin Oncol. 2009 Dec 20;27(36):6101-8. Epub 2009 Nov 16. link to original article contains protocol PubMed

Cyclophosphamide, Etoposide, TBI

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Regimen

Study Evidence
Stiff et al. 1998 Phase II

Preparative regimen

  • Cyclophosphamide (Cytoxan) 100 mg/kg IV over 1 to 2 hours once on day -2
  • Etoposide (Vepesid) 60 mg/kg IV over 4 hours once on day -4
  • Total body irradiation (TBI) with 150 cGy fractions given twice per day (fractions are at least 5 hours apart) x 8 fractions (total dose: 1200 cGy) over 4 days on days -8 to -5, with lung shielding for the final 600 Gy
    • Note: Table 1 of Stiff et al. 1998 lists the dosage of each fraction as being 120 cGy, in contrast to the body text under "treatment regimen" saying each fraction is 150 cGy. It is believed that the 150 cGy dose is correct since 8 fractions of this results in the correct total dose of 1200 cGy.

Supportive medications

References

  1. Stiff PJ, Dahlberg S, Forman SJ, McCall AR, Horning SJ, Nademanee AP, Blume KG, LeBlanc M, Fisher RI. Autologous bone marrow transplantation for patients with relapsed or refractory diffuse aggressive non-Hodgkin's lymphoma: value of augmented preparative regimens--a Southwest Oncology Group trial. J Clin Oncol. 1998 Jan;16(1):48-55. link to original article contains verified protocol PubMed

DHAP -> BEAC

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DHAP: Dexamethasone, High-dose Ara-C (Cytarabine), cisPlatin
BEAC: BiCNU, Etoposide, Ara-C (Cytarabine), Cyclophosphamide

Regimen

Study Evidence
Philip et al. 1991 (Parma) Phase II

DHAP Induction Therapy

In Velasquez, et al. 1988, Ara-C/Cytarabine was originally administered "on the third day," but the regimen was subsequently modified so that it was given on day 2 after cisplatin.

Supportive medications

  • Normal saline solution with mannitol, 50 g/L, at 250 mL/hour IV over 36 hours starting on day 1 prior to cisplatin
  • Metoclopramide (Reglan) 1 mg/kg "given routinely as antiemetics"
  • Diphenhydramine (Benadryl) 25 mg IV "given routinely as antiemetics"

21 to 28 day cycles, depending on degree of myelosuppression, for a total of 2 cycles as follows: After 1 course of DHAP, if they did not have "clearly progressive disease," patients underwent bone marrow harvest. A second course of DHAP was administered starting 1 day after bone marrow harvest. At day 20 after the second course of DHAP, patients were restaged. Patients who showed a response and had bulky disease at initial relapse then started involved field radiotherapy on day 20 after the second course of DHAP for 5 days per week x 2 weeks. In the original Velasquez, et al. 1988 paper where DHAP was used on its own, treatment continued for 6 to 10 cycles in patient who responded to treatment.

BEAC conditioning & transplant

BEAC starts on day 35 after the second course of DHAP. Autologous blood stem cells are infused on day 0.

References

  1. DHAP portion: Velasquez WS, Cabanillas F, Salvador P, McLaughlin P, Fridrik M, Tucker S, Jagannath S, Hagemeister FB, Redman JR, Swan F, et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood. 1988 Jan;71(1):117-22. link to original article contains verified protocol PubMed
  2. BEAC portion: Philip T, Chauvin F, Armitage J, Bron D, Hagenbeek A, Biron P, Spitzer G, Velasquez W, Weisenburger DD, Fernandez-Ranada J, et al. Parma international protocol: pilot study of DHAP followed by involved-field radiotherapy and BEAC with autologous bone marrow transplantation. Blood. 1991 Apr 1;77(7):1587-92. link to original article contains verified protocol PubMed

High-dose Melphalan (Alkeran)

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Regimen - immunoglobulin light-chain (AL) amyloidosis

Study Evidence
Skinner et al. 2004 Phase II

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.

Preparative regimen

  • Patients who fulfilled all of these criteria--<=65 years old, cardiac ejection fraction >=45%, and >=2.5 x 106 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 106 CD34+ cells/kg collected received Melphalan (Alkeran) 140 mg/m2 total dose IV divided over two consecutive days
  • Autologous stem cell infusion occurs 24 to 72 hours after the last dose of melphalan

References

  1. Barlogie B, Hall R, Zander A, Dicke K, Alexanian R. High-dose melphalan with autologous bone marrow transplantation for multiple myeloma. Blood. 1986 May;67(5):1298-301. link to original article PubMed
  2. 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. link to original article contains verified protocol PubMed
  3. Royer B, Minvielle S, Diouf M, Roussel M, Karlin L, Hulin C, Arnulf B, Macro M, Cailleres S, Brion A, Brechignac S, Belhadj K, Chretien ML, Wetterwald M, Chaleteix C, Tiab M, Leleu X, Frenzel L, Garderet L, Choquet S, Fuzibet JG, Dauriac C, Forneker LM, Benboubker L, Facon T, Moreau P, Avet-Loiseau H, Marolleau JP. Bortezomib, Doxorubicin, Cyclophosphamide, Dexamethasone Induction Followed by Stem Cell Transplantation for Primary Plasma Cell Leukemia: A Prospective Phase II Study of the Intergroupe Francophone du Myélome. J Clin Oncol. 2016 Jun 20;34(18):2125-32. Epub 2016 Apr 25. link to original article contains protocol PubMed

R-BEAM

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R-BEAM: Rituximab, BiCNU (Carmustine), Etoposide, Ara-C (Cytarabine), Melphalan

Regimen

Study Evidence
Kirschey et al. 2014 Phase II

A minimum number of 2 × 106/kg bw CD34-positive cells were required to proceed.

Preparative regimen

Autologous blood stem cells are infused on day 0.

Patients in the LyMa trial were then randomized to rituximab maintenance versus observation.

References

  1. Kirschey S, Flohr T, Wolf HH, Frickhofen N, Gramatzki M, Link H, Basara N, Peter N, Meyer RG, Schmitz N, Weidmann E, Banat A, Schulz A, Kolbe K, Derigs G, Theobald M, Hess G. Rituximab combined with DexaBEAM followed by high dose therapy as salvage therapy in patients with relapsed or refractory B-cell lymphoma: mature results of a phase II multicentre study. Br J Haematol. 2015 Mar;168(6):824-34. Epub 2014 Dec 28. link to original article contains verified protocol PubMed
  2. Abstract: Steven Le Gouill, MD, PhD, Catherine Thieblemont, MD, PhD, Lucie Oberic, Krimo Bouabdallah, MD, Emmanuel Gyan, MD, PhD, Gandhi Damaj, MD, Vincent Ribrag, MD, Serge Bologna, MD, Remy Gressin, MD, Olivier Casasnovas, MD, Corinne Haioun, MD, PhD, Philippe Solal-Celigny, MD, Herve Maisonneuve, MD, Eric Van Den Neste, MD, PhD, Anne Moreau, MD, Marie C Bene, Gilles Salles, MD PhD, Hervé Tilly, MD, PhD, Thierry Lamy, MD, PhD and Olivier Hermine, MD, PhD. Rituximab Maintenance Versus Wait and Watch after Four Courses of R-DHAP Followed By Autologous Stem Cell transplantation in Previously Untreated Young Patients with Mantle Cell Lymphoma: First Interim Analysis of the Phase III Prospective Lyma Trial, a Lysa Study. ASH Annual Meeting 2014, Abstract 146 link to abstract

R-TBI/Cy

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R-TBI/Cy: Rituximab, Total, Body, Irradiation, Cyclophosphamide

Regimen

Study Evidence
Kirschey et al. 2014 Phase II

A minimum number of 2 × 106/kg bw CD34-positive cells were required to proceed.

Preparative regimen

References

  1. Kirschey S, Flohr T, Wolf HH, Frickhofen N, Gramatzki M, Link H, Basara N, Peter N, Meyer RG, Schmitz N, Weidmann E, Banat A, Schulz A, Kolbe K, Derigs G, Theobald M, Hess G. Rituximab combined with DexaBEAM followed by high dose therapy as salvage therapy in patients with relapsed or refractory B-cell lymphoma: mature results of a phase II multicentre study. Br J Haematol. 2015 Mar;168(6):824-34. Epub 2014 Dec 28. link to original article contains verified protocol PubMed

TAM6

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Regimen

Study Evidence
Delarue et al. 2012 Phase II

Preparative 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

Supportive medications

"Antimicrobial prophylaxis and use of G-CSF or erythropoietin were permitted according to physician decision."

References

  1. 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. link to original article contains verified protocol PubMed

V-BEAM

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V-BEAM: Velcade (Bortezomib), BiCNU (Carmustine), Etoposide, Ara-C (Cytarabine), Melphalan

Regimen

Study Evidence
William et al. 2014 Phase II

Full details not available in abstract; to be added later.

Preparative regimen

References

  1. William BM, Allen MS, Loberiza FR Jr, Bociek RG, Bierman PJ, Armitage JO, Vose JM. Phase I/II study of bortezomib-BEAM and autologous hematopoietic stem cell transplantation for relapsed indolent non-Hodgkin lymphoma, transformed, or mantle cell lymphoma. Biol Blood Marrow Transplant. 2014 Apr;20(4):536-42. Epub 2014 Jan 14. link to original article PubMed

VMCP & BVAP -> high-dose Melphalan (Alkeran)

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VMCP: Vincristine, Melphalan, Cyclophosphamide, Prednisone
BVAP: BiCNU (Carmustine), Vincristine, Adriamycin (Doxorubicin), Prednisone

Regimen

Study Evidence Comparator
Attal et al. 1996 Phase III VMCP/BVAP alone

VMCP portion

21-day cycles x 2 to 3 cycles, given in an alternating fashion with BVAP

BVAP portion

21-day cycles x 2 to 3 cycles, given in an alternating fashion with VMCP

VMCP and BVAP are given in an alternating fashion x a total of 4 to 6 cycles; patients with a 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:

Preparative regimen

  • 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 treatment started after transplant when ANC >1500/mm3 and platelets >75,000/mm3

References

  1. 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. link to original article contains verified protocol PubMed

Z-BEAM

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Z-BEAM: Zevalin (Ibritumomab tiuxetan), BiCNU (Carmustine), Etoposide, Ara-C (Cytarabine), Melphalan

Regimen #1

Study Evidence Comparator
Shimoni et al. 2012 Randomized Phase II, >20 per arm BEAM
Briones et al. 2013 Phase II

Patients in Shimoni et al. 2012 had primary induction failure or were chemosensitive to salvage therapy. Patients in Briones et al. 2013 had primary induction failure or were refractory to salvage therapy.

Preparative regimen

Supportive medications

Regimen #2

Study Evidence
Fruchart et al. 2014 Phase II

This regimen is intended for upfront consolidation. Patients achieved at least a PR to R-ACVBP or R-CHOP.

Preparative regimen

Supportive medications

  • "According to standard use"

References

  1. Shimoni A, Zwas ST, Oksman Y, Hardan I, Shem-Tov N, Yerushalmi R, Avigdor A, Ben-Bassat I, Nagler A. Yttrium-90-ibritumomab tiuxetan (Zevalin) combined with high-dose BEAM chemotherapy and autologous stem cell transplantation for chemo-refractory aggressive non-Hodgkin's lymphoma. Exp Hematol. 2007 Apr;35(4):534-40. link to SD article PubMed
  2. Shimoni A, Avivi I, Rowe JM, Yeshurun M, Levi I, Or R, Patachenko P, Avigdor A, Zwas T, Nagler A. A randomized study comparing yttrium-90 ibritumomab tiuxetan (Zevalin) and high-dose BEAM chemotherapy versus BEAM alone as the conditioning regimen before autologous stem cell transplantation in patients with aggressive lymphoma. Cancer. 2012 Oct 1;118(19):4706-14. Epub 2012 Jan 17. link to original article contains verified protocol PubMed
  3. Briones J, Novelli S, García-Marco JA, Tomás JF, Bernal T, Grande C, Canales MA, Torres A, Moraleda JM, Panizo C, Jarque I, Palmero F, Hernsández M, González-Barca E, López D, Caballero D. Autologous stem cell transplantation after conditioning with Yttrium-90 ibritumomab tiuxetan plus beam in refractory non-Hodgkin diffuse large B-cell lymphoma: results of a prospective, multicenter, phase II clinical trial. Haematologica. 2014 Mar;99(3):505-10. Epub 2013 Oct 25. link to original article contains verified protocol PubMed
  4. Fruchart C, Tilly H, Morschhauser F, Ghesquières H, Bouteloup M, Fermé C, Van Den Neste E, Bordessoule D, Bouabdallah R, Delmer A, Casasnovas RO, Ysebaert L, Ciappuccini R, Briere J, Gisselbrecht C. Upfront consolidation combining yttrium-90 ibritumomab tiuxetan and high-dose therapy with stem cell transplantation in poor-risk patients with diffuse large B cell lymphoma. Biol Blood Marrow Transplant. 2014 Dec;20(12):1905-11. Epub 2014 Jul 26. link to SD article contains verified protocol PubMed

Allogeneic hematopoietic cell transplant, myeloablative

BEAM

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BEAM: BiCNU (Carmustine), Etoposide, Ara-C (Cytarabine), Melphalan

Regimen

Study Evidence
Przepiorka et al. 1999 Phase II
Sobol et al. 2013 Phase II

Preparative regimen

Supportive medications

References

  1. 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. link to original article contains protocol PubMed
  2. Sobol U, Rodriguez T, Smith S, Go A, Vimr R, Parthasarathy M, Guo R, Stiff P. Seven-year follow-up of allogeneic transplant using BCNU, etoposide, cytarabine and melphalan chemotherapy in patients with Hodgkin lymphoma after autograft failure: importance of minimal residual disease. Leuk Lymphoma. 2014 Jun;55(6):1281-7. Epub 2013 Oct 3. link to original article PubMed

BFR

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BFR: Bendamustine, Fludarabine, Rituximab

Regimen

Study Evidence
Khouri et al. 2014 Phase II

Preparative regimen

Note: the bendamustine infusion instructions are for the Treanda formulation, which was discontinued on 3/31/2016.

GVHD prophylaxis

  • See article for GVHD prophylaxis information

References

  1. Khouri IF, Wei W, Korbling M, Turturro F, Ahmed S, Alousi A, Anderlini P, Ciurea S, Jabbour E, Oran B, Popat UR, Rondon G, Bassett RL Jr, Gulbis A. BFR (bendamustine, fludarabine, and rituximab) allogeneic conditioning for chronic lymphocytic leukemia/lymphoma: reduced myelosuppression and GVHD. Blood. 2014 Oct 2;124(14):2306-12. Epub 2014 Aug 21. link to original article contains verified protocol PubMed

Busulfan & Cyclophosphamide (BuCy)

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Regimen

Study Evidence Comparator
Lee et al. 2013 Phase III Busulfan & Fludarabine
Rambaldi et al. 2015 Phase III Busulfan & Fludarabine

Preparative regimen

Supportive medications

References

  1. Andersson BS, Kashyap A, Gian V, Wingard JR, Fernandez H, Cagnoni PJ, Jones RB, Tarantolo S, Hu WW, Blume KG, Forman SJ, Champlin RE. Conditioning therapy with intravenous busulfan and cyclophosphamide (IV BuCy2) for hematologic malignancies prior to allogeneic stem cell transplantation: a phase II study. Biol Blood Marrow Transplant. 2002;8(3):145-54. link to SD article PubMed
  2. 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. Epub 2012 Nov 5. link to original article contains verified protocol PubMed
  3. Rambaldi A, Grassi A, Masciulli A, Boschini C, Micò MC, Busca A, Bruno B, Cavattoni I, Santarone S, Raimondi R, Montanari M, Milone G, Chiusolo P, Pastore D, Guidi S, Patriarca F, Risitano AM, Saporiti G, Pini M, Terruzzi E, Arcese W, Marotta G, Carella AM, Nagler A, Russo D, Corradini P, Alessandrino EP, Torelli GF, Scimè R, Mordini N, Oldani E, Marfisi RM, Bacigalupo A, Bosi A. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1525-36. Epub 2015 Sep 28. link to original article PubMed

Busulfan & Fludarabine (Flu/Bu; BuFlu)

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Regimen #1

Study Evidence Comparator
Lee et al. 2013 Phase III Busulfan & Cyclophosphamide

Preparative regimen

Supportive medications

Regimen #2

Study Evidence
Russell et al. 2002 Phase II

Preparative regimen

Supportive medications

GVHD prophylaxis

References

  1. 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. link to original article contains verified protocol PubMed
  2. 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. Epub 2012 Nov 5. link to original article contains verified protocol PubMed
  3. Rambaldi A, Grassi A, Masciulli A, Boschini C, Micò MC, Busca A, Bruno B, Cavattoni I, Santarone S, Raimondi R, Montanari M, Milone G, Chiusolo P, Pastore D, Guidi S, Patriarca F, Risitano AM, Saporiti G, Pini M, Terruzzi E, Arcese W, Marotta G, Carella AM, Nagler A, Russo D, Corradini P, Alessandrino EP, Torelli GF, Scimè R, Mordini N, Oldani E, Marfisi RM, Bacigalupo A, Bosi A. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1525-36. Epub 2015 Sep 28. link to original article PubMed

Cyclophosphamide & TBI

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Regimen, Copelan et al. 2013

Retrospective

This was a retrospective study from CIBMTR data; regimen and supportive medication details vary.

Preparative regimen

References

  1. Retrospective: Copelan EA, Hamilton BK, Avalos B, Ahn KW, Bolwell BJ, Zhu X, Aljurf M, van Besien K, Bredeson C, Cahn JY, Costa LJ, de Lima M, Gale RP, Hale GA, Halter J, Hamadani M, Inamoto Y, Kamble RT, Litzow MR, Loren AW, Marks DI, Olavarria E, Roy V, Sabloff M, Savani BN, Seftel M, Schouten HC, Ustun C, Waller EK, Weisdorf DJ, Wirk B, Horowitz MM, Arora M, Szer J, Cortes J, Kalaycio ME, Maziarz RT, Saber W. Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI. Blood. 2013 Dec 5;122(24):3863-70. Epub 2013 Sep 24. link to original article PubMed

Fludarabine, Busulfan, Cyclophosphamide

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Regimen

Study Evidence
Glass et al. 2014 (DSHNHL R3) Non-randomized

This is described by the authors as a lymphoma-directed myeloablative conditioning regimen

Preparative regimen

GVHD prophylaxis

References

  1. Glass B, Hasenkamp J, Wulf G, Dreger P, Pfreundschuh M, Gramatzki M, Silling G, Wilhelm C, Zeis M, Görlitz A, Pfeiffer S, Hilgers R, Truemper L, Schmitz N; on behalf of the German High-Grade Lymphoma Study Group. Rituximab after lymphoma-directed conditioning and allogeneic stem-cell transplantation for relapsed and refractory aggressive non-Hodgkin lymphoma (DSHNHL R3): an open-label, randomised, phase 2 trial. Lancet Oncol. 2014 Jun;15(7):757-66. Epub 2014 May 11. link to original article link to original protocol (in German) contains verified protocol PubMed

Allogeneic hematopoietic cell transplant, reduced-intensity conditioning (RIC)

Busulfan & Fludarabine

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Regimen

Study Evidence
Devine et al. 2015 (CALGB 100103) Phase II, <20 patients in this subgroup

This regimen is meant for related donors; only 8 patients received this regimen before the addition of ATG (rabbit) after 2006.

Preparative regimen

GVHD prophylaxis

  • Tacrolimus (Prograf) with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
  • Methotrexate (MTX) 5 mg/m2 IV once per day on days +1, +3, +6, +11

References

  1. Devine SM, Owzar K, Blum W, Mulkey F, Stone RM, Hsu JW, Champlin RE, Chen YB, Vij R, Slack J, Soiffer RJ, Larson RA, Shea TC, Hars V, Sibley AB, Giralt S, Carter S, Horowitz MM, Linker C, Alyea EP. Phase II Study of Allogeneic Transplantation for Older Patients With Acute Myeloid Leukemia in First Complete Remission Using a Reduced-Intensity Conditioning Regimen: Results From Cancer and Leukemia Group B 100103 (Alliance for Clinical Trials in Oncology)/Blood and Marrow Transplant Clinical Trial Network 0502. J Clin Oncol. 2015 Dec 10;33(35):4167-75. Epub 2015 Nov 2. link to original article contains verified protocol PubMed

Clofarabine & Melphalan

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Regimen

Study Evidence
Middeke et al. 2015 (BRIDGE) Phase II

Limited details are available in the abstract. Treatment is preceded by clofarabine & cytarabine salvage and is meant to be given during aplasia.

Preparative regimen

References

  1. Middeke JM, Herbst R, Parmentier S, Bug G, Hänel M, Stuhler G, Schäfer-Eckart K, Rösler W, Klein S, Bethge W, Bitz U, Büttner B, Knoth H, Alakel N, Schaich M, Morgner A, Kramer M, Sockel K, von Bonin M, Stölzel F, Platzbecker U, Röllig C, Thiede C, Ehninger G, Bornhäuser M, Schetelig J. Clofarabine salvage therapy before allogeneic hematopoietic stem cell transplantation in patients with relapsed or refractory AML: results of the BRIDGE trial. Leukemia. 2016 Feb;30(2):261-7. Epub 2015 Aug 18. link to original article contains protocol PubMed

Cyclophosphamide, Fludarabine, Thiotepa

Regimen

Details to be completed.

Preparative regimen

References

  1. Corradini P, Tarella C, Olivieri A, Gianni AM, Voena C, Zallio F, Ladetto M, Falda M, Lucesole M, Dodero A, Ciceri F, Benedetti F, Rambaldi A, Sajeva MR, Tresoldi M, Pileri A, Bordignon C, Bregni M. Reduced-intensity conditioning followed by allografting of hematopoietic cells can produce clinical and molecular remissions in patients with poor-risk hematologic malignancies. Blood. 2002 Jan 1;99(1):75-82. link to original article PubMed

FCR

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FCR: Fludarabine, Cyclophosphamide, Rituximab

Regimen

Study Evidence
Khouri et al. 2001 Phase II

Details are best described in Khouri et al. 2008.

Preparative regimen

GVHD prophylaxis

References

  1. Khouri IF, Saliba RM, Giralt SA, Lee MS, Okoroji GJ, Hagemeister FB, Korbling M, Younes A, Ippoliti C, Gajewski JL, McLaughlin P, Anderlini P, Donato ML, Cabanillas FF, Champlin RE. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood. 2001 Dec 15;98(13):3595-9. link to original article PubMed
    1. Update: Khouri IF, McLaughlin P, Saliba RM, Hosing C, Korbling M, Lee MS, Medeiros LJ, Fayad L, Samaniego F, Alousi A, Anderlini P, Couriel D, de Lima M, Giralt S, Neelapu SS, Ueno NT, Samuels BI, Hagemeister F, Kwak LW, Champlin RE. Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood. 2008 Jun 15;111(12):5530-6. Epub 2008 Apr 14. Erratum in: Blood. 2009 Feb 12;113(7):1613. link to original article contains verified protocol PubMed
    2. Update: Khouri IF, Saliba RM, Erwin WD, Samuels BI, Korbling M, Medeiros LJ, Valverde R, Alousi AM, Anderlini P, Bashir Q, Ciurea S, Gulbis AM, de Lima M, Hosing C, Kebriaei P, Popat UR, Fowler N, Neelapu SS, Samaniego F, Champlin RE, Macapinlac HA. Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results. Blood. 2012 Jun 28;119(26):6373-8. Epub 2012 May 14. link to original article contains verified protocol PubMed

Fludarabine and Low-dose TBI

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Regimen

Study Evidence Comparator
Maris et al. 2003 Phase II
Sorror et al. 2005 Phase II
Gyukocza et al. 2010 Phase III Low-dose TBI

Details are best described in Maris et al. 2003.

Preparative regimen

  • Fludarabine (Fludara) 30 mg/m2 IV once per day on days -4 to -2
  • Total body irradiation (TBI) 2 Gy at a rate of 0.07 Gy/min on day 0

GVHD prophylaxis

  • Cyclosporine (type not specified) 6.25 mg/kg PO BID starting 4 to 6 hours after transplant, tapered at day 100 over 80 days (if no GVHD)
  • Mycophenolate mofetil (CellCept) 15 mg/kg PO BID starting 4 to 6 hours after transplant, tapered at day 40 over 56 days (if no GVHD)

References

  1. Maris MB, Niederwieser D, Sandmaier BM, Storer B, Stuart M, Maloney D, Petersdorf E, McSweeney P, Pulsipher M, Woolfrey A, Chauncey T, Agura E, Heimfeld S, Slattery J, Hegenbart U, Anasetti C, Blume K, Storb R. HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative conditioning for patients with hematologic malignancies. Blood. 2003 Sep 15;102(6):2021-30. Epub 2003 Jun 5. link to original article contains verified protocol PubMed
  2. Sorror ML, Maris MB, Sandmaier BM, Storer BE, Stuart MJ, Hegenbart U, Agura E, Chauncey TR, Leis J, Pulsipher M, McSweeney P, Radich JP, Bredeson C, Bruno B, Langston A, Loken MR, Al-Ali H, Blume KG, Storb R, Maloney DG. Hematopoietic cell transplantation after nonmyeloablative conditioning for advanced chronic lymphocytic leukemia. J Clin Oncol. 2005 Jun 1;23(16):3819-29. Epub 2005 Apr 4. link to original article PubMed
    1. Update: Sorror ML, Storer BE, Sandmaier BM, Maris M, Shizuru J, Maziarz R, Agura E, Chauncey TR, Pulsipher MA, McSweeney PA, Wade JC, Bruno B, Langston A, Radich J, Niederwieser D, Blume KG, Storb R, Maloney DG. Five-year follow-up of patients with advanced chronic lymphocytic leukemia treated with allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning. J Clin Oncol. 2008 Oct 20;26(30):4912-20. Epub 2008 Sep 15. link to original article PubMed
  3. 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. Epub 2010 May 3. link to original article contains verified protocol PubMed
  4. Björkstrand B, Iacobelli S, Hegenbart U, Gruber A, Greinix H, Volin L, Narni F, Musto P, Beksac M, Bosi A, Milone G, Corradini P, Goldschmidt H, de Witte T, Morris C, Niederwieser D, Gahrton G. Tandem autologous/reduced-intensity conditioning allogeneic stem-cell transplantation versus autologous transplantation in myeloma: long-term follow-up. J Clin Oncol. 2011 Aug 1;29(22):3016-22. Epub 2011 Jul 5. Erratum in: J Clin Oncol. 2011 Sep 20;29(27):3721. link to original article PubMed
    1. Update: Gahrton G, Iacobelli S, Björkstrand B, Hegenbart U, Gruber A, Greinix H, Volin L, Narni F, Carella AM, Beksac M, Bosi A, Milone G, Corradini P, Schönland S, Friberg K, van Biezen A, Goldschmidt H, de Witte T, Morris C, Niederwieser D, Garderet L, Kröger N; EBMT Chronic Malignancies Working Party Plasma Cell Disorders Subcommittee. Autologous/reduced-intensity allogeneic stem cell transplantation vs autologous transplantation in multiple myeloma: long-term results of the EBMT-NMAM2000 study. Blood. 2013 Jun 20;121(25):5055-63. Epub 2013 Mar 12. link to original article PubMed

Fludarabine, Busulfan, ATG

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Regimen #1

Study Evidence
Devine et al. 2015 (CALGB 100103) Phase II

This regimen is meant for all types of donors.

Preparative regimen

GVHD prophylaxis

  • Tacrolimus (Prograf) with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
  • Methotrexate (MTX) 5 mg/m2 IV once per day on days +1, +3, +6, +11

Regimen #2

Study Evidence
Slavin et al. 1998 Phase II

Preparative regimen

Regimen #3

Study Evidence
Mohti et al. 2014 Phase II

Preparative regimen

Supportive care as per Mohty et al. 2003.

References

  1. Slavin S, Nagler A, Naparstek E, Kapelushnik Y, Aker M, Cividalli G, Varadi G, Kirschbaum M, Ackerstein A, Samuel S, Amar A, Brautbar C, Ben-Tal O, Eldor A, Or R. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood. 1998 Feb 1;91(3):756-63. link to original article contains verified protocol PubMed
  2. Mohty M, Malard F, Blaise D, Milpied N, Furst S, Tabrizi R, Guillaume T, Vigouroux S, El-Cheikh J, Delaunay J, Le Gouill S, Moreau P, Labopin M, Chevallier P. Reduced-toxicity conditioning with fludarabine, once-daily intravenous busulfan, and antithymocyte globulins prior to allogeneic stem cell transplantation: results of a multicenter prospective phase 2 trial. Cancer. 2015 Feb 15;121(4):562-9. Epub 2014 Oct 3. Erratum in: Cancer. 2015 Mar 1;121(5):800. link to original article contains verified protocol PubMed
  3. Devine SM, Owzar K, Blum W, Mulkey F, Stone RM, Hsu JW, Champlin RE, Chen YB, Vij R, Slack J, Soiffer RJ, Larson RA, Shea TC, Hars V, Sibley AB, Giralt S, Carter S, Horowitz MM, Linker C, Alyea EP. Phase II Study of Allogeneic Transplantation for Older Patients With Acute Myeloid Leukemia in First Complete Remission Using a Reduced-Intensity Conditioning Regimen: Results From Cancer and Leukemia Group B 100103 (Alliance for Clinical Trials in Oncology)/Blood and Marrow Transplant Clinical Trial Network 0502. J Clin Oncol. 2015 Dec 10;33(35):4167-75. Epub 2015 Nov 2. link to original article contains verified protocol PubMed

Fludarabine, Busulfan, ATG, Ibritumomab tiuxetan

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Regimen

Study Evidence
Bouabdallah et al. 2015 Phase II

Preparative regimen

GVHD prophylaxis

  • Cyclosporine (type and dose not specified) until day +90 and tapered off by day +180 based on chimerism and GVHD
  • Methotrexate (MTX) as follows (for unrelated donors with HLA mismatch):
    • 15 mg/m2 (route not specified) once on day +1
    • 10 mg/m2 (route not specified) once per day on days +3 & +6

References

  1. Bouabdallah K, Furst S, Asselineau J, Chevalier P, Tournilhac O, Ceballos P, Vigouroux S, Tabrizi R, Doussau A, Bouabdallah R, Mohty M, Le Gouill S, Blaise D, Milpied N. 90Y-ibritumomab tiuxetan, fludarabine, busulfan and antithymocyte globulin reduced-intensity allogeneic transplant conditioning for patients with advanced and high-risk B-cell lymphomas. Ann Oncol. 2015 Jan;26(1):193-8. Epub 2014 Oct 30. link to original article contains verified protocol PubMed

Fludarabine & Cyclophosphamide

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Regimen

Study Evidence
Dreger et al. 2010 (CLL3X) Phase II

This regimen is intended for related donors.

Preparative regimen

References

  1. Dreger P, Döhner H, Ritgen M, Böttcher S, Busch R, Dietrich S, Bunjes D, Cohen S, Schubert J, Hegenbart U, Beelen D, Zeis M, Stadler M, Hasenkamp J, Uharek L, Scheid C, Humpe A, Zenz T, Winkler D, Hallek M, Kneba M, Schmitz N, Stilgenbauer S; German CLL Study Group. Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial. Blood. 2010 Oct 7;116(14):2438-47. Epub 2010 Jul 1. link to original article contains verified protocol PubMed
    1. Update: Dreger P, Schnaiter A, Zenz T, Böttcher S, Rossi M, Paschka P, Bühler A, Dietrich S, Busch R, Ritgen M, Bunjes D, Zeis M, Stadler M, Uharek L, Scheid C, Hegenbart U, Hallek M, Kneba M, Schmitz N, Döhner H, Stilgenbauer S. TP53, SF3B1, and NOTCH1 mutations and outcome of allotransplantation for chronic lymphocytic leukemia: six-year follow-up of the GCLLSG CLL3X trial. Blood. 2013 Apr 18;121(16):3284-8. Epub 2013 Feb 22. link to original article PubMed

Fludarabine, Cyclophosphamide, ATG

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Regimen

Study Evidence
Dreger et al. 2010 (CLL3X) Phase II

This regimen is intended for unrelated donors.

Preparative regimen

References

  1. Dreger P, Döhner H, Ritgen M, Böttcher S, Busch R, Dietrich S, Bunjes D, Cohen S, Schubert J, Hegenbart U, Beelen D, Zeis M, Stadler M, Hasenkamp J, Uharek L, Scheid C, Humpe A, Zenz T, Winkler D, Hallek M, Kneba M, Schmitz N, Stilgenbauer S; German CLL Study Group. Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial. Blood. 2010 Oct 7;116(14):2438-47. Epub 2010 Jul 1. link to original article contains verified protocol PubMed
    1. Update: Dreger P, Schnaiter A, Zenz T, Böttcher S, Rossi M, Paschka P, Bühler A, Dietrich S, Busch R, Ritgen M, Bunjes D, Zeis M, Stadler M, Uharek L, Scheid C, Hegenbart U, Hallek M, Kneba M, Schmitz N, Döhner H, Stilgenbauer S. TP53, SF3B1, and NOTCH1 mutations and outcome of allotransplantation for chronic lymphocytic leukemia: six-year follow-up of the GCLLSG CLL3X trial. Blood. 2013 Apr 18;121(16):3284-8. Epub 2013 Feb 22. link to original article PubMed

Fludarabine, Cyclophosphamide, TBI for dUCB or haploidentical transplant

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dUCB: double Umbilical Cord Blood

Regimen #1, dUCB transplantation

Study Evidence
Brunstein et al. 2011 Phase II

Preparative regimen

Supportive medications

  • Mesna (Mesnex) (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
  • Filgrastim (Neupogen) 5 µg/kg SC once per day, starting on day +1, continued until ANC =2000/µL for 3 consecutive days

GVHD Prophylaxis

  • Mycophenolate mofetil (CellCept) 1000 mg (route not specified) Q8H for patients >50 kg, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
    • Patients <50 kg received Mycophenolate mofetil (CellCept) 15 mg/kg (route not specified) Q8H, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
  • Cyclosporine A (Neoral vs. Sandimmune not specified, route not specified) with a goal trough of 200 to 400 ng/mL (starting date not specified) until day +100. Patients without GVHD had their dose tapered by 10% each week starting on day +101, with discontinuation of cyclosporine A around day +180 to +200.
  • Tacrolimus (Prograf) (route not specified) with a goal trough level of 5 to 10 ng/mL could be substituted for cyclosporine.

Regimen #2, Haploidentical

Study Evidence
Brunstein et al. 2011 Phase II

Preparative regimen

Supportive medications

  • Mesna (Mesnex) (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
  • Filgrastim (Neupogen) 5 µg/kg SC once per day, starting on day +5, continued until ANC =1000/µL for 3 consecutive days

GVHD Prophylaxis

  • Cyclophosphamide (Cytoxan) 50 mg/kg IBW IV over 1 to 2 hours once per day on days +3 (60 to 72 hours after marrow infusion) and +4
  • Mycophenolate mofetil (CellCept) 15 mg/kg (maximum daily dose of 3000 mg; route not specified) Q8H, starting on day +5, continued until day +35 or longer at physician discretion if active GVHD was present
  • Tacrolimus (Prograf) (route not specified) with a goal trough level of 5 to 10 ng/mL, starting on day +5, continued until day +180

References

  1. Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J, Devine SM, Wingard JR, Aljitawi OS, Cutler CS, Jagasia MH, Ballen KK, Eapen M, O'Donnell PV;Blood and Marrow Transplant Clinical Trials Network. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood. 2011 Jul 14;118(2):282-8. link to original article contains verified protocol PubMed

Fludarabine & Melphalan

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Regimen #1

Study Evidence
Sureda et al. 2011 Phase II

Preparative regimen

Recipients of stem cells from matched unrelated donors also received:

GVHD prophylaxis

  • Cyclosporine A (not specified whether modified or non-modified) starting at 1.5 mg/kg BID IV on day -2
  • Methotrexate (MTX) 10 mg/m2 IV once per day on days +1, +3, +6 and +11

If no acute GVHD of grade 2 or more, cyclosporine A is tapered down by 10% per week starting on day +90 with planned discontinuation by day +180.

Regimen #2

Study Evidence
Anderlini et al. 2008 Phase II

Preparative regimen

Recipients of stem cells from matched unrelated donors also received:

GVHD prophylaxis

  • Tacrolimus (Prograf) IV starting on day -2, dosed to achieve serum levels 4–12 ng/mL and switched to PO as soon as possible. Continued for at least 6 months and then "tapered off" (instructions not given).
  • Methotrexate (MTX) 5 mg/m2 IV once per day on days +1, +3, +6 (extra dose on day +11 for MUD recipients)

References

  1. Alvarez I, Sureda A, Caballero MD, Urbano-Ispizua A, Ribera JM, Canales M, García-Conde J, Sanz G, Arranz R, Bernal MT, de la Serna J, Díez JL, Moraleda JM, Rubió-Félix D, Xicoy B, Martínez C, Mateos MV, Sierra J. Nonmyeloablative stem cell transplantation is an effective therapy for refractory or relapsed hodgkin lymphoma: results of a spanish prospective cooperative protocol. Biol Blood Marrow Transplant. 2006 Feb;12(2):172-83. link to original article contains protocol PubMed
  2. Anderlini P, Saliba R, Acholonu S, Giralt SA, Andersson B, Ueno NT, Hosing C, Khouri IF, Couriel D, de Lima M, Qazilbash MH, Pro B, Romaguera J, Fayad L, Hagemeister F, Younes A, Munsell MF, Champlin RE. Fludarabine-melphalan as a preparative regimen for reduced-intensity conditioning allogeneic stem cell transplantation in relapsed and refractory Hodgkin's lymphoma: the updated M.D. Anderson Cancer Center experience. Haematologica. 2008 Feb;93(2):257-64. Epub 2008 Jan 26. link to original article contains verified protocol PubMed
  3. Sureda A, Canals C, Arranz R, Caballero D, Ribera JM, Brune M, Passweg J, Martino R, Valcárcel D, Besalduch J, Duarte R, León A, Pascual MJ, García-Noblejas A, López Corral L, Xicoy B, Sierra J, Schmitz N. Allogeneic stem cell transplantation after reduced intensity conditioning in patients with relapsed or refractory Hodgkin's lymphoma. Results of the HDR-ALLO study - a prospective clinical trial by the Grupo Español de Linfomas/Trasplante de Médula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Haematologica. 2012 Feb;97(2):310-7. Epub 2011 Oct 11. link to original article contains protocol PubMed

Low-dose TBI

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Regimen

Study Evidence Comparator
Gyukocza et al. 2010 Phase III Fludarabine and Low-dose TBI

Preparative regimen

  • Total body irradiation (TBI) 2 Gy at a rate of 0.07 to 0.20 Gy/min on day 0

GVHD prophylaxis

References

  1. 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. Epub 2010 May 3. link to original article contains verified protocol PubMed

(90)YFC

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(90)YFC: Ibritumomab tiuxetan, Fludarabine, Cyclophosphamide

Regimen

Study Evidence
Khouri et al. 2012 Non-randomized

Preparative regimen

GVHD prophylaxis

References

  1. Khouri IF, Saliba RM, Erwin WD, Samuels BI, Korbling M, Medeiros LJ, Valverde R, Alousi AM, Anderlini P, Bashir Q, Ciurea S, Gulbis AM, de Lima M, Hosing C, Kebriaei P, Popat UR, Fowler N, Neelapu SS, Samaniego F, Champlin RE, Macapinlac HA. Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results. Blood. 2012 Jun 28;119(26):6373-8. Epub 2012 May 14. link to original article contains verified protocol PubMed

Supportive care, hepatic veno-occlusive disease (VOD)

Also known as sinusoidal obstructive syndrome (SOS)

Defibrotide (Defitelio)

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Regimen

Study Evidence Comparator
Richardson et al. 2016 Phase III "32 historical controls"

Regimen details

Given for at least 21 days. If after 21 days signs and symptoms of VOD have not resolved, give until VOD is resolved, up to a maximum of 60 days.

References

  1. Richardson PG, Riches ML, Kernan NA, Brochstein JA, Mineishi S, Termuhlen AM, Arai S, Grupp SA, Guinan EC, Martin PL, Steinbach G, Krishnan A, Nemecek ER, Giralt S, Rodriguez T, Duerst R, Doyle J, Antin JH, Smith A, Lehmann L, Champlin R, Gillio A, Bajwa R, D'Agostino RB Sr, Massaro J, Warren D, Miloslavsky M, Hume RL, Iacobelli M, Nejadnik B, Hannah AL, Soiffer RJ. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood. 2016 Jan 29. link to original article contains verified protocol PubMed
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