Systemic Anti-Cancer Therapy Regimen Library
LEU AML - MACE [amsacrine, cytarabine and etoposide]
Treatment Overview
Frequency: Every 28 days or on count recovery.
Cycle 1 - 28 days
Cycle details
Cycle 1 - 28 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| amsacrine | 100 mg/m² Once daily | intravenous | 1 to 5 | 60 minutes |
| cytarabine | 200 mg/m² Once daily | intravenous | 1 to 5 | 22 hours |
| etoposide (as phosphate) | 100 mg/m² Once daily | intravenous | 1 to 5 | 60 minutes |
Full details
Cycle 1 - 28 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| amsacrine | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Must be diluted in glucose 5%. Incompatible with sodium chloride 0.9%. Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
| cytarabine | 200 mg/m² Once daily | intravenous | 22 hours |
Instructions:
Do not infuse at same time as amsacrine infusion. |
| etoposide (as phosphate) | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Do not infuse at same time as amsacrine infusion. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| amsacrine | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Must be diluted in glucose 5%. Incompatible with sodium chloride 0.9%. Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
| cytarabine | 200 mg/m² Once daily | intravenous | 22 hours |
Instructions:
Do not infuse at same time as amsacrine infusion. |
| etoposide (as phosphate) | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Do not infuse at same time as amsacrine infusion. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| amsacrine | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Must be diluted in glucose 5%. Incompatible with sodium chloride 0.9%. Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
| cytarabine | 200 mg/m² Once daily | intravenous | 22 hours |
Instructions:
Do not infuse at same time as amsacrine infusion. |
| etoposide (as phosphate) | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Do not infuse at same time as amsacrine infusion. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| amsacrine | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Must be diluted in glucose 5%. Incompatible with sodium chloride 0.9%. Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
| cytarabine | 200 mg/m² Once daily | intravenous | 22 hours |
Instructions:
Do not infuse at same time as amsacrine infusion. |
| etoposide (as phosphate) | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Do not infuse at same time as amsacrine infusion. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| amsacrine | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Must be diluted in glucose 5%. Incompatible with sodium chloride 0.9%. Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
| cytarabine | 200 mg/m² Once daily | intravenous | 22 hours |
Instructions:
Do not infuse at same time as amsacrine infusion. |
| etoposide (as phosphate) | 100 mg/m² Once daily | intravenous | 60 minutes |
Instructions:
Do not infuse at same time as amsacrine infusion. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Antifungal prophylaxis: | Routine antifungal prophylaxis recommended |
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis recommended |
| Emetogenicity: | Low |
Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.
References
AML15 protocol Version 2 January 2004 https://www.skion.nl/workspace/uploads/English-protocol-website-version.pdf (accessed 8 August 2022).
Cancer Care Ontario Drug Monograph Amsacrine September 2011 https://www.cancercareontario.ca/en/drugformulary/drugs/amsacrine (accessed 8 August 2022).
Eurocept International BV Amsidine Summary of product characteristics 30 March 2022 https://www.medicines.org.uk/emc/product/13279/smpc#gref (accessed 11 July 2022).
* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.
s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.