Systemic Anti-Cancer Therapy Regimen Library
LEU T-PLL Relapsed - pentostatin
Treatment Overview
Give until a maximum response (e.g. normalisation of blood counts) has been achieved then for a further 2 cycles—10 cycles are normally required.
Depending on response and toxicity less than 10 cycles may be given.
If a partial response (based on blood counts) not achieved after 4 cycles, pentostatin should be discontinued.
Cycles 1 to 10 - 14 days
Cycle details
Cycles 1 to 10 - 14 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| sodium chloride 0.45% (38 mmol/500 mL) + glucose 2.5% | 500 mL | intravenous | 1 | 60 minutes |
| pentostatin | 4 mg/m² | intravenous | 1 | 30 minutes |
| sodium chloride 0.45% (38 mmol/500 mL) + glucose 2.5% | 500 mL | intravenous | 1 | 60 minutes |
Full details
Cycles 1 to 10 - 14 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| sodium chloride 0.45% (38 mmol/500 mL) + glucose 2.5% | 500 mL | intravenous | 60 minutes |
Instructions:
Prior to pentostatin as hydration, or as per institutional practice. |
| pentostatin | 4 mg/m² | intravenous | 30 minutes | |
| sodium chloride 0.45% (38 mmol/500 mL) + glucose 2.5% | 500 mL | intravenous | 60 minutes |
Instructions:
Immediately after pentostatin as hydration, or as per institutional practice. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Antifungal prophylaxis: | Routine antifungal prophylaxis may be considered |
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis recommended |
| Emetogenicity: | Low |
| Hydration: | Routine hydration recommended |
| Irradiated blood components: | Irradiation of blood components is recommended |
| Pneumocystis jirovecii pneumonia (PJP) prophylaxis: | Routine antibiotic prophylaxis recommended |
| Tumour lysis syndrome prophylaxis: | Tumour lysis syndrome prophylaxis is recommended |
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
Thames Valley Strategic Clinical Network Pentostatin (Hairy Cell Leukaemia) Regimen v1.7 July 2021 http://nssg.oxford-haematology.org.uk/lymphoma/documents/lymphoma-chemo-protocols/L-15-pentostatin.pdf (Accessed 4 August 2022).
Hospira UK Limited Nipent product information 13 January 2021 https://www.medicines.org.uk/emc/product/6197#CLINICAL_PARTS (accessed 20 January 2022).
New Zealand Blood Service Transfusion Medicine Handbook Third Edition, 2016 https://www.nzblood.co.nz/assets/Transfusion-Medicine/PDFs/111G122.pdf (accessed 3/2/2022).
* 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.