Difference between revisions of "Example orders for CHOEP in lymphoma"
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'''Clinical scenario & comments:''' | '''Clinical scenario & comments:''' | ||
*44 year-old lady with primary mediastinal lymphoma; 7 cm anterior mediastinal mass, [[Performance_status|ECOG performance status 0]]. | *44 year-old lady with primary mediastinal lymphoma; 7 cm anterior mediastinal mass, [[Performance_status|ECOG performance status 0]]. | ||
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Revision as of 00:50, 20 September 2012
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
CHOEP
CHOEP: Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Etoposide, Prednisone
Original references may be found at CHOEP
Example regimen #1
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV on day 1
- Vincristine (Oncovin) 2 mg IV on day 1
- Etoposide (Vepesid) 100 mg/m2 IV on days days 1-3
- Prednisone (Sterapred) 100 mg PO on days 1-5
- Patients with initial bulky disease (mass conglomerate at least 7.5 cm) received 36 Gy radiation therapy and to extranodal sites of disease when possible
21-day cycles x 6 cycles
Supportive medications:
- Fosaprepitant (Emend injection) 150 mg IV x1 on day 1 prior to chemotherapy
- Ondansetron (Zofran) 8 mg IV 30 minutes prior to chemotherapy
- Allopurinol (Aloprim) as described below
Hydration:
- 500 ml NS and/or D5W KVO rate to be used as running IV for chemotherapy infusion. Give up to 500 ml NS and/or D5W.
Monitoring:
- On days 1, 3, 8, and 17 of cycle 1: CBC with differential, absolute neutrophil count (ANC), comprehensive metabolic panel (chem 10 and LFTs), LDH, uric acid; future labs to be determined based on patient's cycle 1 counts
- Prior to start of therapy, check beta-2 microglobulin, SPEP, IgG, IgA, IgM
- Initial staging with CT torso & bone marrow biopsy
- In anticipation of rituxan use starting cycle 2, check hepatitis B surface antibody (HbsAb), hepatitis B surface antigen (HbsAg), hepatitis B core antibody (HbcAb), hepatitis C antibody (HCV Ab)
Outpatient medications:
- Acyclovir (Zovirax) 400 mg PO TID
- Allopurinol (Aloprim) 300 mg PO daily
- Filgrastim (Neupogen) 300 mcg (patient is 63 kg) SC daily on days 4-13
- Ondansetron (Zofran) 8 mg PO TID
- Pantoprazole (Protonix) 40 mg PO daily
- Prednisone (Sterapred) as described above
- Docusate (Colace) 100 mg PO BID prn constipation
- Sennosides (Senna) 8.6 mg PO Q8H prn constipation
Clinical scenario & comments:
- 44 year-old lady with primary mediastinal lymphoma; 7 cm anterior mediastinal mass, ECOG performance status 0.