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CSC BMT Fludarabine-Busulfan VER 4-11-17 (HL 4451)

CSC BMT Fludarabine-Busulfan VER 4-11-17 (HL 4451) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Beacon Protocols, BMT


CSC BMT FLUDARABINE/BUSULFAN VER: 4-11-17 – Properties
Conditioning Regimen for Allogeneic Transplant – 4/11/2017 through 4/28/2017 (18 days), Planned
Treatment Orders for Day -6 through Day 11, Conditioning Regimen for Allogeneic
Transplant – Planned for 4/11/2017
Treatment Plan Information
Reference Information (1)
Acute Myelogenous Leukemia (AML) / Myelodysplastic Syndrome (MDS): deLima M, et al. Blood 2004;104(3):857-64.
Reference Information (2)
Acute Myelogenous Leukemia (AML): Rambaldi A, et al. Lancet Oncol 2015;16(15):1525-36.
Reference Information (3)
Acute Myelogenous Leukemia (AML) / Myelodysplastic Syndrome (MDS): deLima M, et al. Blood 2006;108(11).
Reference Information (4)
Acute Myelogenous Leukemia (AML): Santarone S, et.al. Biol Blood Marrow Transplant 2011:17(10):1505-11
Reference Information (5)
Acute Lymphoblastic Leukemia/ Lymphoma (ALL): Shin HC, et al. Korean J Intern Med 2012;27(1):72-83.
Treatment Plan Summary
DISEASE: Acute Myelogenous Leukemia (AML), Myelodysplastic Syndrome (MDS), Acute Lymphoblastic Leukemia/ Lymphoma
(ALL); THERAPY: fludarabine 40 mg/m2 IV daily Day -6, -5, -4, -3 followed immediately by busulfan 130 mg/m2 IV daily Day -6, -5,
-4, -3, methotrexate 15 mg/m2 IV on Day +1, methotrexate 10 mg/m2 IV on Day +3, +6, +11 (Graft vs Host Disease prophylaxis);
CYCLE LENGTH: 8 days; COURSE: 1 cycle.
Consent
Verify Consent
Verify informed consent has been obtained.
Additional Labs
METHOTREXATE
ONCE Starting S+13 at 0000
METHOTREXATE
ONCE Starting S+18 at 0000
Treatment Conditions
Verify Medication(s) Taken at Home (1)
Verify that patient has taken levetiracetam and document in a progress note. Notify authorizing prescriber if patient has not taken
medication as prescribed.
Hydration
dextrose 5%-NaCl 0.45% with KCl 20 mEq/L infusion
Intravenous, CONTINUOUS, For 3 days Starting when released until S+3 at 2359
Day -6 through Day -3: Administer at a rate of 2 L/m2/24h
dextrose 5%-NaCl 0.45% with KCl 20 mEq/L infusion
at 100 mL/hr, Intravenous, CONTINUOUS Starting S+4 at 0000 Until Discontinued
Day -2: Reduce IV rate to 100 mL/h.
Pre-Medications
dexamethasone (DECADRON) tab 8 mg
8 mg, Oral, EVERY 24 HOURS, 4 doses Starting when released
Day -6 through Day -3: Administer prior to chemotherapy.
dexamethasone (DECADRON) 10 MG/ML injection 8 mg
8 mg, Intravenous, EVERY 24 HOURS PRN, For 96 hours Starting when released, If unable to tolerate PO
Day -6 through Day -3: Administer prior to chemotherapy.
ondansetron (ZOFRAN) tab 24 mg
24 mg, Oral, EVERY 24 HOURS, 4 doses Starting when released
Day -6 through Day -3: Administer prior to chemotherapy.
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ZZtestonc,Andrew [2428787]
4/11/2017 3:28:44 PM Page 1 of 2
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 04/2017CCKM@uwhealth.org

ondansetron (ZOFRAN) 16 mg in sodium chloride 0.9 % 50 mL bag
16 mg, Intravenous, EVERY 24 HOURS PRN, For 96 hours Starting when released, nausea/vomiting, if unable to tolerate PO
Day -6 through Day -3: Administer prior to chemotherapy.
Treatment Medications
fludarabine (FLUDARA) 40 mg/m2 in sodium chloride 0.9 % 100 mL bag
40 mg/m2, Intravenous, EVERY 24 HOURS, 4 doses Starting when released
Day -6 through Day -3.
busulfan (BUSULFEX) 130 mg/m2 in sodium chloride 0.9 % 500 mL bag
130 mg/m2, Intravenous, EVERY 24 HOURS, 4 doses Starting when released
Day -6 through Day -3: Administer immediately following fludarabine.
tacrolimus cap
Oral, EVERY 12 HOURS Starting S+3 at 0000
Day -3: Dose = 0.12 mg/kg/day in two divided doses based on Actual body weight. May switch to IV tacrolimus if patient unable to
tolerate PO.
methotrexate PF (TREXALL) injection 15 mg/m2 (Treatment Plan)
15 mg/m2, Intravenous, ONCE, 1 dose Starting S+7 at 0000
Day +1. Administer 24 hours after the completion of stem cell infusion. IV push rate 10 mg/minute.
methotrexate PF (TREXALL) injection 10 mg/m2 (Treatment Plan)
10 mg/m2, Intravenous, ONCE, 1 dose Starting S+9 at 0000
Day +3. Check with BMT team before administering dose. IV push rate 10 mg/minute.
methotrexate PF (TREXALL) injection 10 mg/m2 (Treatment Plan)
10 mg/m2, Intravenous, ONCE, 1 dose Starting S+12 at 0000
Day +6. Check with BMT team before administering dose. IV push rate 10 mg/minute.
methotrexate PF (TREXALL) injection 10 mg/m2 (Treatment Plan)
10 mg/m2, Intravenous, ONCE, 1 dose Starting S+17 at 0000
Day +11. Check with BMT team before administering dose. IV push rate 10 mg/minute.
Supportive Care Medications
levetiracetam (KEPPRA) tab 500 mg
500 mg, Oral, 2 X DAILY, 10 doses Starting when released
Day -6 through Day -2.
Take Home Medications
levetiracetam (KEPPRA) 500 MG tab
Take 1 tab by mouth 2 times daily. Day -7., 500 mg, Disp-2 tab, R-0, 2 X DAILY starting S, Local Printer
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ZZtestonc,Andrew [2428787]
4/11/2017 3:28:44 PM Page 2 of 2
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
04/2017CCKM@uwhealth.org