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Systemic Anti-Cancer Therapy Regimen Library

UKALL14 with RITUximab [over 40 years] [for transplant] - Consolidation [Cycle 4] (LEU ALL precursor B-cell - UKALL14 with RITUximab [over 40 years] [for transplant])

Treatment Overview

Start after count recovery from Consolidation/delayed intensification Cycle 3, with neutrophils greater than 0.75 x 109/L and platelets greater than 75 x 109/L.

Cycle 1 - 21 days

Cycle length:
21

cytarabine: Administer by subcutaneous injection (as above) or alternatively administer intravenously as per institutional practice.


metHOTREXATe intrathecal:

  • Day of administration can be moved +/- 3 days.
  • For Ommaya reservoir reduce dose to 6 mg intraventricularly.

Cycle details

Cycle 1 - 21 days

Medication Dose Route Days Max Duration
cytarabine 75 mg/m² Once daily subcutaneous injection 1 to 5
etoposide (as phosphate) * 100 mg/m² Once daily intravenous 1 to 5 60 minutes
metHOTREXATe 12 mg flat dosing intrathecal injection 1

cytarabine: Administer by subcutaneous injection (as above) or alternatively administer intravenously as per institutional practice.


metHOTREXATe intrathecal:

  • Day of administration can be moved +/- 3 days.
  • For Ommaya reservoir reduce dose to 6 mg intraventricularly.

Full details

Cycle 1 - 21 days

Day: 1

Medication Dose Route Max duration Details
cytarabine 75 mg/m² Once daily subcutaneous injection
Instructions:

Or administer intravenously as per institutional practice.

etoposide (as phosphate) * 100 mg/m² Once daily intravenous 60 minutes
metHOTREXATe 12 mg flat dosing intrathecal injection
Instructions:
  • Day of administration can be moved +/- 3 days.
  • Adhere to local institution policy for intrathecal administration.
  • For Ommaya reservoir reduce dose to 6 mg intraventricularly.

Day: 2

Medication Dose Route Max duration Details
cytarabine 75 mg/m² Once daily subcutaneous injection
Instructions:

Or administer intravenously as per institutional practice.

etoposide (as phosphate) * 100 mg/m² Once daily intravenous 60 minutes

Day: 3

Medication Dose Route Max duration Details
cytarabine 75 mg/m² Once daily subcutaneous injection
Instructions:

Or administer intravenously as per institutional practice.

etoposide (as phosphate) * 100 mg/m² Once daily intravenous 60 minutes

Day: 4

Medication Dose Route Max duration Details
cytarabine 75 mg/m² Once daily subcutaneous injection
Instructions:

Or administer intravenously as per institutional practice.

etoposide (as phosphate) * 100 mg/m² Once daily intravenous 60 minutes

Day: 5

Medication Dose Route Max duration Details
cytarabine 75 mg/m² Once daily subcutaneous injection
Instructions:

Or administer intravenously as per institutional practice.

etoposide (as phosphate) * 100 mg/m² Once daily intravenous 60 minutes

Supportive Care Factors

Factor Value
Antifungal prophylaxis: Routine antifungal prophylaxis recommended
Antiviral prophylaxis for hepatitis B virus: Required for anti–HBc positive patients at risk of reactivation
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
Emetogenicity: Low
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis recommended

References

No references

* 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.