Example orders for ABVD in Hodgkin lymphoma
Revision as of 18:19, 2 July 2012 by PeterYang (talk | contribs) (Created page with "'''Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.''' {{TOC...")
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
ABVD
ABVD: Adriamycin, Bleomycin, Vinblastine, Dacarbazine
Original reference may be found at ABVD
Example regimen #1
- Doxorubicin (Adriamycin) 25 mg/m2 IV on days 1 & 15
- Given as IV push through running IV.
- Bleomycin (Blenoxane) 10 units/m2 IV on days 1 & 15
- For cycle 1 only: Bleomycin (Blenoxane) 1 unit test dose infused over 15 minutes. Observe patient for 60 minutes prior to administering the remainder of the full dose.
- Infuse over 30 minutes after premedication with acetaminophen (Tylenol).
- Vinblastine (Velban) 6 mg/m2 IV on days 1 & 15
- Given as IV push through running IV.
- Dacarbazine (DTIC) 375 mg/m2 IV on days 1 & 15
- Given over 60 minutes, with rate adjustments as needed based on patient tolerability.
28-day cycles x 6 cycles
Supportive medications:
- Acetaminophen (Tylenol) 650 mg PO 30 minutes prior to chemotherapy
- Diphenhydramine (Benadryl) 25 mg PO 30 minutes prior to chemotherapy
- Ondansetron (Zofran) 8 mg PO 30 minutes prior to chemotherapy
- Aprepitant (Emend) 125 mg PO on days 1 & 15, 80 mg PO on days 2-3, 16-17
- Dexamethasone (Decadron) 4 mg PO BID on days 1-3, 15-17
Hydration:
- 500 ml NS and/or D5W at KVO rate as running IV for chemotherapy infusion. Give up to 500 ml NS and/or D5W as needed for IV compatibility.
Monitoring:
- On day 1 & 15 of each cycle: CBC with differential, absolute neutrophil count (ANC), comprehensive metabolic panel (including chem 10 & liver function tests (LFTs), LDH, uric acid
- Physician to be notified if LFTs/bilirubin are outside normal limits, ANC <1000, platelets <100.
- Check pulmonary function test (PFTs) with DLCO (diffusing capacity of the lung for carbon monoxide) prior to starting therapy and after 3-4 cycles of therapy. May perform PFTs as soon as after 2 cycles in high risk patients, such as recent smokers.
- Smoking cessation for smokers given risk of bleomycin pulmonary toxicity.
- Echocardiogram prior to start of therapy.
- Restage with PET/CT after 3 cycles of therapy.
Outpatient medications:
- Aprepitant (Emend) & Dexamethasone (Decadron) as described above in Supportive medications.
- Trimethoprim/Sulfamethoxazole (Bactrim SS) 80/400 mg PO daily for PCP prophylaxis
- Ondansetron (Zofran) 8 mg PO TID prn nausea
- Prochlorperazine (Compazine) 10 mg PO Q6H prn nausea
Clinical scenario & comments:
- 28 year-old gentleman with stage IIIAs Hodgkin lymphoma, treated with 6 cycles of ABVD.