CODOX-M/IVAC

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Non-Hodgkin's Lymphoma

Burkitt's Lymphoma, high risk patients

Cycle 1 and 3 ( CODOX-M )

  • Cyclophosphamide (Cytoxan) 800 mg/m2 iv d1
  • Cyclophosphamide (Cytoxan) 200 mg/m2/d iv d2-5
  • Doxorubicin (Adriamycin) 40 mg/m2 iv d1
  • Vincristine 1.5 mg/m2 iv d1, 8 for cycle 1 and d1, 8, 15 for cycle 3
  • Methotrexate(MTX) 1200 mg/m2 iv over 1 h d10, then 240 mg/m2 per hour civi for the next 23 hrs
  • Leucovorin 50 mg iv q6h begins 36 hrs from the start of MTX till MTX level < 0.05 uM
  • Filgrastim (Neupogen) begins 24 hrs from the start of Leucovorin till ANC > 1000/mL

CNS prophylaxis:

  • Intrathecal Ara-C 70 mg d1 and 3, MTX 12 mg d15

CNS treatment:

  • Cycle 1: Intrathecal Ara-C 70 mg d1, 3 and 5, MTX 12 mg d15 and 17
  • Cycle 3: Intrathecal Ara-C 70 mg d1 and 3, MTX 12 mg d15

Cycle 2 and 4 ( IVAC )

  • Ifosfamide 1500 mg/m2/d iv d1-5
  • Etoposide (VP-16) 60 mg/m2/d iv d1-5
  • Cytarabine (Ara-C) 2000 mg/m2 iv q12h d1 and 2 (total 4 doses)
  • Filgrastim (Neupogen) begins 24 hrs after completion of chemotherapy till ANC > 1000/mL

CNS prophylaxis:

  • Intrathecal MTX 12 mg d5

CNS treatment:

  • Cycle 2: Intrathecal MTX 12 mg d5, Ara-C 70 mg d7 and 9
  • Cycle 4: Intrathecal MTX 12 mg d5

Radiotherapy for CNS disease and testicular involvement

References

Magrath, I et al. Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol 1996; 14:925