Common Chemotherapy Regimens

Portions of treatment regimens may be given as outpatient. All regimens are subject to variation.

Hyper CVAD (ALL)

Cycles 1, 3, 5, 7

Day 1 / Day 2 / Day 3 / Day 4 / Day 5* / Day 8 / Day 11
Cyclophosphamide + Mesna / Cyclophosphamide + Mesna / Cyclophosphamide + Mesna
Vincristine / Vincristine
Doxurubicin
Dexamethasone* / Dexamethasone / Dexamethasone / Dexamethasone / Dexamethasone
IT Methotrexate / IT Cytarabine
Urine heme check / Urineheme check / Urineheme check / Urineheme check
Neulasta

*Day 5 and beyond will be outpatient. Dexamethasone also given day 11-4

Cycle 2, 4, 6, 8

Day 1 / Day 2 / Day 3 / Day 4 / Day 5 / Day 8
Methotrexate
Cytarabine
Leucovorin * / Leucovorin / Leucovorin / Leucovorin
Methylprednisolone / Methylprednisolone / Methylprednisolone
IT Methotrexate / IT Cytarabine
Urine pH / Urine pH / Urine pH / Urine pH
Neulasta

*started 12 hours after methotrexate, continued until methotrexate levels are <0.1

7+3 (AML)

Day 1 / Day 2 / Day 3 / Day 4 / Day 5 / Day 6 / Day 7
Cytarabine / Cytarabine / Cytarabine / Cytarabine / Cytarabine / Cytarabine / Cytarabine
Daunorubicin / Daunorubicin / Daunorubicin

Consolidation Cytarabine (AML)

Day 1 / Day 2 / Day 3 / Day 4 / Day 5 / Day 6
Cytarabine q12 / Cytarabine q12 / Cytarabine q12 / Neulasta

R-CHOP (Non-Hodgkins Lymphoma)

Day 1 / Day 2 / Day 3 / Day 4 / Day 5
Rituximab
Vincristine
Doxurubicin
Cyclophosphamide
Prednisone / Prednisone / Prednisone / Prednisone / Prednisone

R-EPOCH (Aggressive Non-Hodkins Lymphoma)

Day 1 / Day 2 / Day 3 / Day 4 / Day 5 / Day 6
Rituximab
Etoposide / Etoposide / Etoposide / Etoposide
Vincristine / Vincristine / Vincristine / Vincristine
Doxurubicin / Doxurubicin / Doxurubicin / Doxurubicin
Cyclophosphamide
Prednisone / Prednisone / Prednisone / Prednisone / Prednisone*
Neulasta/Neupogen

*Continued until Day 14

Discharge Checklist for AML/ALL

  • Discharge destination and home needs
  • Discharge medications
  • Prophylactic antibiotics*
  • Medication changes
  • Follow up appointments
  • With primary oncologist
  • Follow up chemotherapy appointments
  • Neulasta injection appointment
  • Transfusion appointments
  • CBC with type and screen
  • Patient Counseling

Transplant Patient Checklist

  • Stem cell infusion is Day 0, all days prior are negative (I.e. -1, -2), days following are positive
  • Antibiotic prophylaxis:
  • Fluconazole
  • Acyclovir
  • Bactrim (hold when ANC <1.0)
  • Levofloxacin (start when ANC <500)
  • Encourage ice chips to avoid mucositis
  • Weekly CXR
  • Weekly blood cultures
  • PT/OT

Prophylactic Antibiotics

All Leukemia patients discharged after chemo need prophylaxis, regardless of current ANC

  • AML:
  • Acyclovir
  • Posaconazole
  • Ciprofloxacin
  • ALL, immunosuppressed lymphoma:
  • Acyclovir
  • Fluconazole
  • Ciprofloxacin
  • Long term steroids:
  • Bactrim
  • Transplant:
  • Fluconazole
  • Acyclovir
  • Bactrim (hold when ANC <1.0)
  • Levofloxacin (start when ANC <500)

Important Phone Numbers

Cancer Center main – 272-2496

New patient scheduling – 272-2839

Established patient scheduling –925-0140

Heme/onc pharmacist – 604-1219

Marissa Gibson (NP) - 238-3466

3 East – 925-4667

5 East – 272-2770

ECOG Scale

0 / Fully active, no restrictions
1 / Strenuous physical activity restricted, fully ambulatory, able to carry out light work
2 / Capable of all self care, unable to carry out work activities. Up and about >50% of waking hours
3 / Capable of only limited self care, confined to bed or chair >50% of waking hours
4 / Completely disabled, cannot carry out any self care, totally confined to bed or chair