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

Treatment Overview

Differentiation syndrome:

Monitor closely for differentiation syndrome in the first 7 to 10 days of treatment.
Prompt recognition is necessary and if syndrome develops treat promptly with high dose intravenous corticosteroids (dexamethasone 10 mg/m² IV Q12H) for at least 3 days and until complete resolution of symptoms.
Decision to withhold tretinoin should be only for severe cases or if lack of response to corticosteroid.

Continue Induction treatment with tretinoin until complete remission is achieved, or for a maximum of 90 days.

Cycle 1 - 90 days

Cycle length:

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.
Continue Induction treatment with tretinoin only until a complete remission is achieved, or for a maximum of 90 days.

IDArubicin: Administer first dose (day 1) within a few hours of starting tretinoin.

Cycle details

Cycle 1 - 90 days

Medication	Dose	Route	Days	Max Duration
tretinoin	45 mg/m² Daily in divided doses	oral administration	1 to 90
IDArubicin *	12 mg/m²	intravenous	1, 3, 5, 7	15 minutes
dexamethasone	2.5 mg/m² Twice daily	oral administration	1 to 15

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.
Continue Induction treatment with tretinoin only until a complete remission is achieved, or for a maximum of 90 days.

IDArubicin: Administer first dose (day 1) within a few hours of starting tretinoin.

Full details

Cycle 1 - 90 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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
IDArubicin *	12 mg/m²	intravenous	15 minutes	Instructions: Administer within a few hours of starting tretinoin. Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
IDArubicin *	12 mg/m²	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.
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
IDArubicin *	12 mg/m²	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.
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
IDArubicin *	12 mg/m²	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.
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects
dexamethasone	2.5 mg/m² Twice daily	oral administration		Instructions: Take with food.

Day: 16

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 17

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 18

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 19

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 20

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 21

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 22

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 23

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 24

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 25

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 26

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 27

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 28

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 29

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 30

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 31

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 32

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 33

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 34

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 35

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 36

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 37

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 38

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 39

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 40

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 41

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 42

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 43

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 44

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 45

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 46

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 47

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 48

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 49

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 50

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 51

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 52

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 53

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 54

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 55

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 56

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 57

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 58

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 59

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 60

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 61

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 62

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 63

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 64

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 65

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 66

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 67

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 68

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 69

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 70

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 71

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 72

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 73

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 74

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 75

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 76

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 77

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 78

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 79

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 80

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 81

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 82

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 83

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 84

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 85

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 86

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 87

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 88

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 89

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

Day: 90

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/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Continue only until complete remission, or for a maximum of 90 days. Additional details: Section 1: Teratogenic effects

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 recommended
Antiviral prophylaxis for herpes virus:	Routine antiviral prophylaxis recommended
Emetogenicity:	Variable
Gastroprotection:	Gastroprotection may be considered
Pneumocystis jirovecii pneumonia (PJP) prophylaxis:	Routine antibiotic prophylaxis may be considered
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.

Emetogenicity:

MEDIUM days 1, 3, 5 and 7;
MINIMAL to LOW (oral) days 1 to 90 (excluding 1, 3, 5 and 7).

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.

Cancer Type —

Systemic Anti-Cancer Therapy Regimen Library

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

Treatment Overview

Cycle 1 - 90 days

Cycle details

Cycle 1 - 90 days

Full details

Cycle 1 - 90 days

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Cancer Type
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