Systemic Anti-Cancer Therapy Regimen Library
LYM NHL B-cell PCNSL - R-MP [RITUximab, metHOTREXATe and procarbazine] followed by procarbazine maintenance [65 years and over]
Treatment Overview
This regimen is intended for those 65 years and over.
It consists of TWO parts:
- R-MP [RITUximab, metHOTREXATe and procarbazine] for 3 cycles, followed by
- procarbazine maintenance.
Intrathecal therapy
- Required if CSF cytology/flow positive at diagnosis and after 2 cycles of induction.
- See LYM NHL B-cell - Intrathecal Triple Therapy [metHOTREXATe, cytarabine and hydrocortisone].
Follows R-MP after complete response.
Starts on day 43 of last R-MP cycle.
Supportive Care Factors
| Factor | Value |
|---|---|
| Antiviral prophylaxis for hepatitis B virus: | Required for anti–HBc positive patients at risk of reactivation |
| Antiviral prophylaxis for herpes virus: | Variable |
| Emetogenicity: | Variable |
| Folinic acid rescue for high dose methotrexate: | Variable |
| Hydration: | Variable |
| Hypersensitivity / Infusion related reaction risk: | Variable |
| Pneumocystis jirovecii pneumonia (PJP) prophylaxis: | Variable |
| Tumour lysis syndrome prophylaxis: | Variable |
References
Waikato DHB PRIMAIN prescription chart and personal communication with Dr Vidya Mathavan (consultant Haematologist) 28th January 2022.
Medicines and Hepatitis B Reactivation Prescriber Update 38(1): 2-3 March 2017 https://medsafe.govt.nz/profs/PUArticles/March2017/MedicinesAndHepatitisB.htm
Rituximab and Hepatitis B Reactivation Prescriber Update 34(3):27 September 2013 https://www.medsafe.govt.nz/profs/PUArticles/Sept2013RituximabHepB.htm
* 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.