Difference between revisions of "EPOCH-DA"

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m (Supportive medications)
m
Line 8: Line 8:
 
  Doxorubicin 10 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 40 mg/m2)
 
  Doxorubicin 10 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 40 mg/m2)
 
  Cyclophosphamide 750 mg/m2 IV over 2 hours once on day 5
 
  Cyclophosphamide 750 mg/m2 IV over 2 hours once on day 5
 
  
 
21-day cycles x 6 to 8 cycles
 
21-day cycles x 6 to 8 cycles
 +
 
=== Supportive medications ===
 
=== Supportive medications ===
  
 
Filgrastim (Neupogen) 300 mcg sc once per day, starting on day 6 and continuing until ANC > 5,000/uL past nadir<br/>
 
Filgrastim (Neupogen) 300 mcg sc once per day, starting on day 6 and continuing until ANC > 5,000/uL past nadir<br/>
 
Trimethoprim/Sulfamethoxazole (Bactrim DS) 160/800 mg (or equivalent if allergic) PO once per day on 3 days per week<br/>
 
Trimethoprim/Sulfamethoxazole (Bactrim DS) 160/800 mg (or equivalent if allergic) PO once per day on 3 days per week<br/>
 +
 +
=== Dose adjustments===
 +
Start cycle 1 as described above.
 +
Obtain CBCs twice per week for nadir measurements.
 +
If nadir ANC >500, increase etoposide, doxorubicin, and cyclophosphamide by one level (20%) compared to previous cycle.
 +
If nadir ANC <500, use same doses as last cycle.
 +
If nadir platelet count <25,000, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to the previous cycle.

Revision as of 07:19, 29 August 2013

Regimen

R-EPOCH-DA: Dose Adjusted EPOCH Regimen, Dunleavy, et al. 2013

Rituximab 375 mg/m2 IV over 3 hours once on day 1
Etoposide 50 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 200 mg/m2)
Prednisolone 60 mg/m2 PO BID on days 1 to 5
Vincristine  0.4 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 1.6 mg/m2)
Doxorubicin 10 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 40 mg/m2)
Cyclophosphamide 750 mg/m2 IV over 2 hours once on day 5

21-day cycles x 6 to 8 cycles

Supportive medications

Filgrastim (Neupogen) 300 mcg sc once per day, starting on day 6 and continuing until ANC > 5,000/uL past nadir
Trimethoprim/Sulfamethoxazole (Bactrim DS) 160/800 mg (or equivalent if allergic) PO once per day on 3 days per week

Dose adjustments

Start cycle 1 as described above. Obtain CBCs twice per week for nadir measurements. If nadir ANC >500, increase etoposide, doxorubicin, and cyclophosphamide by one level (20%) compared to previous cycle. If nadir ANC <500, use same doses as last cycle. If nadir platelet count <25,000, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to the previous cycle.