AML17 Trial APL AIDA Induction ATRA Ida

Canterbury DHB (Blood, Cancer and Palliative Care Service) Page 1 of 3

AML 17 - APL Height cm Consolidation Weight kg ATRA with Arsenic Trioxide BSA m2

Patient trial number:

Destination BMTU Limits Hypersensitivities/Allergies Agent Round Cycle 1 of 4 Date ATRA 10mg Neuts Idarubicin 1mg Plats DOSE MODIFIED: No Yes PRN antiemetics Reference: AML 17 trial protocol ± domperidone 20mg PO QID

Day Date Time Agent Dose Route Instructions Doctor Nurse Check Start Stop 1 Tretinoin (ATRA) 45mg/m2 mg PO Administered daily in 2 equally divided doses, for 2 weeks on followed by 2 weeks off, for a total of 7 cycles. Chart on QMR4 or outpatient script. 1 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.3mg/kg mg IV In 250ml 0.9% saline over 2 hours. 2 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.3mg/kg mg IV In 250ml 0.9% saline over 2 hours.

 You must read the protocol before prescribing this chemotherapy. * Patients with a WCC > 10 X 109/l should receive gemtuzumab on day 1 and on day 4 if the WCC has not fallen below 10 X 109/l, otherwise delete. * Two doses of Rasburicase can be given on day 1 to prevent tumour lysis. * Monitor closely for signs of differentiation (ATRA) syndrome and tumorlysis syndrome. See Red book for details.

Patient Category: OSP Group: Consultant: Special Authority Y J A P O 1 3 Z 1 2 3 4 5 6 7 NZMC Reg. No:

Authorised by: PI RL Spearing Pharmacist: B Harden February 2011 D:\Docs\2018-04-06\076778f9f2ba8c74cdf8baab76c334ad.doc Review 2012 0 7 0 0 6 2 C T R A H C N O T A C D E M Y P A R E H T O M E H C I I Canterbury DHB (Blood, Cancer and Palliative Care Service) Page 2 of 3

AML 17 - APL AIDA treatment Height cm Consolidation Weight kg ATRA-IDA BSA m2

Day Date Time Agent Dose Route Instructions Doctor Nurse Check Start Stop 3 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.3mg/kg mg IV In 250ml 0.9% saline over 2 hours. 4 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.3mg/kg mg IV In 250ml 0.9% saline run over 2 hrs. 5 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.3mg/kg mg IV In 250ml 0.9% saline run over 2 hrs.

Authorised by: PI RL Spearing Pharmacist: B Harden February 2011 D:\Docs\2018-04-06\076778f9f2ba8c74cdf8baab76c334ad.doc Review 2012 0 7 0 0 6 2 C T R A H C N O T A C D E M Y P A R E H T O M E H C I I Canterbury DHB (Blood, Cancer and Palliative Care Service) Page 3 of 3

AML 17 - APL AIDA treatment Height cm Consolidation Weight kg ATRA-IDA BSA m2

WEEK Date Time Agent Dose Route Instructions Doctor Nurse Check Start Stop 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.25mg/kg mg IV In 250ml 0.9% saline over 2 hours. 2 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.25mg/kg mg IV In 250ml 0.9% saline over 2 hours. 3 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.25mg/kg mg IV In 250ml 0.9% saline over 2 hours. 3 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.25mg/kg mg IV In 250ml 0.9% saline over 2 hours. 4 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.25mg/kg mg IV In 250ml 0.9% saline over 2 hours. 4 0.9% saline 100 ml IV for flushing Arsenic trioxide 0.25mg/kg mg IV In 250ml 0.9% saline over 2 hours.

Authorised by: PI RL Spearing Pharmacist: B Harden February 2011 D:\Docs\2018-04-06\076778f9f2ba8c74cdf8baab76c334ad.doc Review 2012 0 7 0 0 6 2 C T R A H C N O T A C D E M Y P A R E H T O M E H C I I