Systemic Anti-Cancer Therapy Regimen Library
Manchester Protocol [mitoxantrone and cytarabine IV] consolidation (LEU AML - Manchester Protocol [mitoxantrone and cytarabine IV] induction followed by consolidation)
Treatment Overview
Frequency: Every 28 days or on count recovery.
DO NOT use maintenance treatment following consolidation.
Cycles 1 to 2 - 28 days
cytarabine: Give first dose 12 hours prior to mitoxantrone.
Cycle details
Cycles 1 to 2 - 28 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| cytarabine | 100 mg/m² Twice daily | intravenous | 1 to 5 | 30 minutes |
| mitoxantrone | 10 mg/m² Once daily | intravenous | 1, 2 | 30 minutes |
cytarabine: Give first dose 12 hours prior to mitoxantrone.
Full details
Cycles 1 to 2 - 28 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| cytarabine | 100 mg/m² Twice daily | intravenous | 30 minutes |
Instructions:
Give first dose 12 hours prior to mitoxantrone, then every 12 hours. |
| mitoxantrone | 10 mg/m² Once daily | intravenous | 30 minutes |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| cytarabine | 100 mg/m² Twice daily | intravenous | 30 minutes |
Instructions:
Every 12 hours. |
| mitoxantrone | 10 mg/m² Once daily | intravenous | 30 minutes |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| cytarabine | 100 mg/m² Twice daily | intravenous | 30 minutes |
Instructions:
Every 12 hours. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| cytarabine | 100 mg/m² Twice daily | intravenous | 30 minutes |
Instructions:
Every 12 hours. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| cytarabine | 100 mg/m² Twice daily | intravenous | 30 minutes |
Instructions:
Every 12 hours. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Antifungal prophylaxis: | Routine antifungal prophylaxis recommended |
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis recommended |
| Emetogenicity: | Low |
| Growth factor support: | Variable |
| Tumour lysis syndrome prophylaxis: | Tumour lysis syndrome prophylaxis may be considered |
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.
Growth factor support: Consider after the consolidation cycle if in complete remission.
Tumour lysis syndrome prophylaxis: Recommended if not in complete remission.
References
Baxter Healthcare Ltd ONKOTRONE Data sheet 22 October 2020 https://www.medsafe.govt.nz/profs/datasheet/o/Onkotroneinj.pdf (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.