Hyper-CVAD and MTX/HIDAC Regimen

Question 1

Cycles 1, 3, 5, and 7

Answer 1

Cyclophosphamide (+ Mesna) [Days 1-3]
Vincristine [Day 4, Day 11?]
Doxorubicin [Day 4]
Dexamethasone [Days 1-4, 11-14?]
Pre-meds: acetaminophen, dex, zof
Post: G-CSF injection

Question 2

Cycles 2, 4, 6, and 8

Answer 2

Methotrexate (+ Leucovorin) (Day 1)
Cytarabine (Day 2 and Day 3)

Pre: methylpred on Days 1-3
Post: G-CSF injection

Question 3

Cyclophosphamide dose

Answer 3

300 mg/m2 IV
Over 3 hours
q12h on Days 1-3 (6 doses)

Question 4

Mesna dose

Answer 4

600 mg/m2/day IV on Days 1-3
Can be cont. or run over 18h/day (6h free for other meds); must start 1h prior to cyclophosphamide

Question 5

Vincristine dose

Answer 5

2 mg, IVPB ONLY
Who gives and how?

Question 6

Doxorubicin dose

Answer 6

50 mg/m2 IV
Who gives and how?

Question 7

Dexamethasone dose

Answer 7

40 mg PO daily days 1-4, 11-14

Question 8

MTX dose

Answer 8

Start: 200 mg/m2 IVPB over 2h, followed by: 800 mg/m2 IVPB over 22h on Day 1

Why the loading dose?

Question 9

Leucovorin dose

Answer 9

50 mg (route?), 12h after COMPLETION of MTX, followed by 15 mg q6h x8 doses; dose adjusted based on MTX levels.

Labs for this?

Question 10

Cytarabine dose

Answer 10

3 g/m2 IVPB over 2h, q12h on Days 2-3 (four doses)

Question 11

Methylprednisolone dose

Answer 11

50 mg IV, twice daily on days 1-3

Question 12

Granulocyte-Colony Stimulating Factor dose

Answer 12

10 nanograms/kg/d SQ, starting after chemo round completion