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Systemic Anti-Cancer Therapy Regimen Library

Home > LEU APL - Pethema LPA2005 induction and consolidations 1, 2 and 3 followed by maintenance [under 60 years] [high risk] > LEU - Pethema LPA2005 consolidation 1 [under 60 years] [high risk]
This regimen is a component of LEU APL - Pethema LPA2005 induction and consolidations 1, 2 and 3 followed by maintenance [under 60 years] [high risk]

Pethema LPA2005 [under 60 years] [high risk] - Consolidation 1 (LEU APL - Pethema LPA2005 induction and consolidations 1, 2 and 3 followed by maintenance [under 60 years] [high risk])

Treatment Overview

Starts after count recovery from Induction, with neutrophils greater than 1.5 x 109/L and platelets greater than 100 x 109/L. 

Cycle 1 - 28 days

Cycle length:
28

tretinoin:

  • Consider dose reduction of tretinoin to 25 mg/m2 daily in TWO divided doses in patients under 20 years of age to reduce risk of pseudotumour cerebri.
  • Teratogenic—Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.

Cycle details

Cycle 1 - 28 days

Medication Dose Route Days Max Duration
tretinoin * 45 mg/m² Daily in divided doses oral administration 1 to 15
IDArubicin * 5 mg/m² Once daily intravenous 1 to 4 15 minutes
cytarabine 1000 mg/m² Once daily intravenous 1 to 4 6 hours
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye 1 to 6

tretinoin:

  • Consider dose reduction of tretinoin to 25 mg/m2 daily in TWO divided doses in patients under 20 years of age to reduce risk of pseudotumour cerebri.
  • Teratogenic—Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.

Full details

Cycle 1 - 28 days

Day: 1

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:
IDArubicin * 5 mg/m² Once daily intravenous 15 minutes
Instructions:

Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
cytarabine 1000 mg/m² Once daily intravenous 6 hours
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 6.

Day: 2

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:
IDArubicin * 5 mg/m² Once daily intravenous 15 minutes
Instructions:

Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
cytarabine 1000 mg/m² Once daily intravenous 6 hours
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 6.

Day: 3

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:
IDArubicin * 5 mg/m² Once daily intravenous 15 minutes
Instructions:

Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
cytarabine 1000 mg/m² Once daily intravenous 6 hours
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 6.

Day: 4

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:
IDArubicin * 5 mg/m² Once daily intravenous 15 minutes
Instructions:

Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
cytarabine 1000 mg/m² Once daily intravenous 6 hours
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 6.

Day: 5

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 6.

Day: 6

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 6.

Day: 7

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 8

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 9

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 10

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 11

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 12

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 13

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 14

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 15

Medication Dose Route Max duration Details
tretinoin * 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Consider dose reduction to 25 mg/m2 daily in patients under 20 years.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Additional details

Section 1: Teratogenic effects

Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.

Supportive Care Factors

Factor Value
Antifungal prophylaxis: Routine antifungal prophylaxis may be considered
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
Emetogenicity: Variable
Ocular toxicity risk: High - administer corticosteroid eyedrops to minimise corneal toxicity

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.


Emetogenicity:

  • MEDIUM days 1 to 4;
  • MINIMAL to LOW (oral) days 5 to 15.

References

Pharmaco (NZ) Ltd Vesanoid® New Zealand data sheet 21 April 2022 https://www.medsafe.govt.nz/profs/datasheet/v/Vesanoidcap.pdf (accessed 15 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.