BIOL 101 Study Guide - Quiz Guide: Liver Cancer, Anemia, Chromosome
1
Protocol for Fanconi Anemia
F/CTX/ATG
Pre-Transplant Assessment:
• Patients should not be on androgens ,and those
who did receive androgens ,transplant should be
postponed one month after stopping androgens and
they should be screened with abdominal
ultrasonagraphy for any hepatic tumors eg hepatic
adenomas. Any patient with hepatic adenoma
should be screened monthly with abdominal
ultrasonagraphy and not to be transplanted until
significance clearance of the adenoma.
• Siblings should be screened for chromosome
breakage test and avoid any one positive for the test
to be used as a donor.
BMT UNIT
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2
Patient’s Name: -
MRNO
Isolation: day –7 (day--/--/20--)
IV hydration:
Hydration is started 12 hours before conditioning (
day -7)
• 500cc half normal saline iv /6 hours +1 ampoule
potassium
• 500cc D5w. iv +Ca gluconate 1 amp/12hours
• 500cc Ringer + Mg sulphate 1 amp(1gm)/d
• Premedicate with granisteron 1mg +2amp decadron
+150cc D5w over 1 hour starting day -6( --/--/20--),
d every 12 hours regularly till 24 hours after last
dose of chemotherapy, ie till day -2
Height:
weight:
BSA:
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3
Conditioning Regimen:
• Fludarabine ( prefer (11 AM)
Fludarabine 30mg/m2( )+10ml 0.9%
saline daily day -6 till d-2(days --/--,--/--,--/---,---/---20--)
• .Cyclophosphamide( prefer 10 AM):
o Cyclophosphamide 5mg/kg( ) in 50ml
0.9% saline IV prior to fludarabine day -5 till
day -2 ( days --/--;--/---;--/---and --/--/20--)
o On --/--/20--(day-5) give mesna.(20% of CTX
dose) 1mg/kg (------mg) over 30 minutes 4
hours before CTX then every 4 hours till 36
hours after last CTX dose days ;days–5, –4, -3,
-2) (days --/--,--/--,--/---/20--) Have patient void
every 2hours on days CTX given.
o Frusemide 20 mg IV 1 hour and 6hour after
CTX dose day -5 and day -2).
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Document Summary
Pre-transplant assessment: patients should not be on androgens ,and those who did receive androgens ,transplant should be postponed one month after stopping androgens and they should be screened with abdominal ultrasonagraphy for any hepatic tumors eg hepatic adenomas. +150cc d5w over 1 hour starting day -6( --/--/20--), d every 12 hours regularly till 24 hours after last dose of chemotherapy, ie till day -2. Conditioning regimen: fludarabine ( prefer (11 am) Fludarabine 30mg/m2( )+10ml 0. 9% saline daily day -6 till d-2(days --/--,--/--,--/---,---/---20--: . cyclophosphamide( prefer 10 am), cyclophosphamide 5mg/kg( ) in 50ml. 2) (days --/--,--/--,--/---/20--) have patient void every 2hours on days ctx given: frusemide 20 mg iv 1 hour and 6hour after. Atg (rabbit lymphoglobulin grafalon): 5mg/kg/d days-5 to -2 or thymoglogulin 2. 5mg/kg/d d-5 to d-2. 2. 5mg/kg(thymoglobulin ) (-------) in 250-500 ml sodium chloride 0. 9% and infuse over 18 hours. If tolerated, subsequent doses can be given over 12-18hours.
