Example orders for Pralatrexate (Folotyn) in peripheral T-cell lymphoma

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Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.

Pralatrexate (Folotyn)

Published regimens and references can be found on the T-cell lymphoma page.

Example order set #1

• Pralatrexate (Folotyn) 30 mg/m2 IV push over 3 to 5 minutes once per day on days 1, 8, 15, 22, 29, 36

7-week cycles, given until progression of disease or unacceptable toxicity

Supportive medications:

• Ondansetron (Zofran) 8 mg IV once 30 minutes prior to chemotherapy
• Prochlorperazine (Compazine) 10 mg PO once prn nausea
• Cyanocobalamin (Vitamin B12) 1 mg IM once every 8 to 10 weeks
• Folic acid 1 mg PO once per day

Hydration:

• Normal saline IV continuous infusion at 5 mL/H
• Normal saline 25 to 50 mL IV prn flush before and after chemotherapy

Monitoring/precautions:

• Suggested to check weekly CBC; check comprehensive metabolic panel (includes renal and hepatic function) before week 1 & 4 doses
• Examine patient for mucositis before each dose of pralatrexate
• Notify physician and hold dose if ANC <1000, platelet count <50,000

Nursing:

• Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
• Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.