Systemic Anti-Cancer Therapy Regimen Library
High dose cytarabine Consolidation (LYM NHL B-cell PCNSL - R-MPV [RITUximab, metHOTREXATe, procarbazine and vinCRISTine] followed by high dose cytarabine)
Treatment Overview
Commence after the completion of R-MPV/R-MV Induction +/- whole brain radiation therapy (WBRT) as per clinician discretion.
Frequency: Every 28 days or on count recovery for 2 cycles.
This regimen contains a medicine where one or more biosimilars may exist. Any biosimilars used have been reviewed by the regulator (Medsafe) and relevant specialists were consulted nationally. Where regulators, in consultation with relevant specialists, have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably.
Cycles 1 to 2 - 28 days
Cycle details
Cycles 1 to 2 - 28 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| cytarabine * | 2000 mg/m² Twice daily | intravenous | 1, 2 | 3 hours |
| prednisolone acetate 1% (10 mg/mL) eye drops * | 1 Drop Every four hours | application to the eye | 1 to 4 | |
| pegFILGRASTIM | 6 mg | subcutaneous injection | 4 |
Full details
Cycles 1 to 2 - 28 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| cytarabine * | 2000 mg/m² Twice daily | intravenous | 3 hours |
Instructions:
Every 12 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 4. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| cytarabine * | 2000 mg/m² Twice daily | intravenous | 3 hours |
Instructions:
Every 12 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 4. |
Day: 3
| Medication | Dose | Route | Max duration | 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 4. |
Day: 4
| Medication | Dose | Route | Max duration | 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 4. |
|
| pegFILGRASTIM | 6 mg | subcutaneous injection |
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: | Routine antiviral prophylaxis may be considered |
| Emetogenicity: | Medium |
| Growth factor support: | Recommended for primary prophylaxis |
| Ocular toxicity risk: | High - administer corticosteroid eyedrops to minimise corneal toxicity |
| Pneumocystis jirovecii pneumonia (PJP) prophylaxis: | Routine antibiotic prophylaxis may be considered |
| Tumour lysis syndrome prophylaxis: | Tumour lysis syndrome prophylaxis may be considered |
References
Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.
* 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.