PHAR 503 Study Guide - Quiz Guide: Dlco, Ejection Fraction, Meninges
20 May 2018
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Department
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Professor
Sharma et al. SpringerPlus 2013, 2:489 and Experimental and Clinical
Transplantation (2012) 2: 163-167
LEAM protocol over 6days
Indications
• Aggressive non-Hodgkin's lymphoma: chemosensitive
relapsed disease or poor prognostic disease.
• Hodgkin's disease refractory to conventional therapy
or in second remission.
• Indolent non-Hodgkin's disease refractory to second-line
therapy.
Eligibility criteria:
age <60years, ECOG 0-2, chemosensitive lymphoma without
active secondary spread to the CNS (parenchymal brain,
leptomeninges) with complete or partial response, Bone marrow
>50%, PFTs [FVC, FEV1, DLCO] > 60% predicted, creatinine
< 1.7mg/dl, Bilirubin <2 x ULN, no evidence of cirrhosis ,
Height Weight
BSA
BMT UNIT
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Sharma et al. SpringerPlus 2013, 2:489 and Experimental and Clinical
Transplantation (2012) 2: 163-167
ability to give informed consent , no serious active infections
(HIV, TB, HBeAg, active bacterial/fungal disease)
Suggested Fluid Regimen
• Start day-7or day -4 according to longer or shorter
protocol respectively ( --/--/20--) 500mls 0.9% NaCl +
20mmoles KCl + 1ampoule magnesium given over 3
hours every 12hours alternating with dextrose 5% 500cc
every 12hours ( ie total IV fluids /day 2 liters to be
• DO NOT allow patient to get into significantly positive
fluid balance give Frusemide as appropriate.
Conditioning:
Lomustine:
200mg/m2 PO day -6( --/--/20)
Cytarabine:
Cytarbine 200mg/m2 in 100cc 0.9% NaCl over 30minutes twice
daily day-5 to day-2 ( --/--,--/--,---/--and --/--/20 )
Etoposide:
200mg/m2 infusion in 500cc 0.9% NaCl over 2hours day-5 to
day -2( --/--,--/--,---/--and --/--/20 )
Melphalan:
140mg/m2 infusion in 250cc 0.9% NaCl over 30minutes within
3hours of reconstitution day -1 ( --/--/20)
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Document Summary
Indications relapsed disease or poor prognostic disease: aggressive non-hodgkin"s lymphoma: chemosensitive, hodgkin"s disease refractory to conventional therapy, indolent non-hodgkin"s disease refractory to second-line or in second remission. therapy. Eligibility criteria: age <60years, ecog 0-2, chemosensitive lymphoma without active secondary spread to the cns (parenchymal brain, leptomeninges) with complete or partial response, bone marrow infiltration 20% , adequate major organ function: lvef. >50%, pfts [fvc, fev1, dlco] > 60% predicted, creatinine. < 1. 7mg/dl, bilirubin <2 x uln, no evidence of cirrhosis , Transplantation (2012) 2: 163-167 ability to give informed consent , no serious active infections (hiv, tb, hbeag, active bacterial/fungal disease) Suggested fluid regimen: start day-7or day -4 according to longer or shorter protocol respectively ( --/--/20--) 500mls 0. 9% nacl + Cytarbine 200mg/m2 in 100cc 0. 9% nacl over 30minutes twice daily day-5 to day-2 ( --/--,--/--,---/--and --/--/20 ) 200mg/m2 infusion in 500cc 0. 9% nacl over 2hours day-5 to day -2( --/--,--/--,---/--and --/--/20 )
