<p> Canterbury Regional Cancer and Blood Service (Haematology) Page 1 of 5 Lymphobla Height stic Weight Lymphoma BSA Hyper- CVAD This alternates with MTX Ara C</p><p>Cycle length: 21 days CBC Allergies/Hypersensitivities: Agent Round Cycle no Date Cyclophosphamide days 20mg Destination Neuts Antiemetics 2-4 Q12H 0.2mg Vincristine days 5 and 12 5mg Plts . ± domperidone 10-20mg PO QID (2 doses) ± Lorazepam 1-2mg PO daily Doxorubicin day 5 dexamethasone days 2-5 and 12-15 DOSE MODIFIED: Reference: Thomas et al Blood, 2004 104(6) 1624- 1630 </p><p>Day D Time Agent Do Route Instructions Doctor Nurse Start Stop a se t e 1-4 Dexamethasone 40 mg PO (days 1-4 and 11-14) Prescribe on QMR4/outpatient script daily for 4 days 1 T- Ondansetron 8 mg PO Give 30-60 minutes prior to chemo 6</p><p>Authorised by Peter Ganly Pharmacist: Bevan Harden November 2012 D:\Docs\2018-04-19\0d852c7db864e360e834d3ba2a4e8bf9.docx Review September 2013 Canterbury Regional Cancer and Blood Service (Haematology) Page 2 of 5</p><p>0</p><p> m</p><p> in</p><p> x</p><p>T Cyclophospham mg IV In 100ml 0.9S over 2 hours Q12H = 2 0 ide 300mg/m</p><p>0.9% Sodium 100 ml IV For flushing Chloride Ondansetron 8 mg PO Give 30-60 minutes prior to chemo T Cyclophospham mg IV In 100ml 0.9S over 2 hours Q12H 2 + ide 300mg/m</p><p>1</p><p>2</p><p> h</p><p>0.9% Sodium 100 ml IV For flushing Chloride 2 Methotrexate See intrathecal chemotherapy chart 12mg IT 2 Ondansetron 8 mg PO Give 30-60 minutes prior to chemo T Cyclophospham mg IV In 100ml 0.9S over 2 hours Q12H = 2 0 ide 300mg/m</p><p>0.9% Sodium 100 ml IV For flushing Chloride  Encourage patients to drink at least 3 litres of fluid per day, and to void frequently when receiving cyclophosphamide.  Hyper CVAD consists of 2 regimes – Hyper CVAD and High dose Methotrexate and Cytarabine Arabinoside. A full cycle consists of both regimes given 21 days apart.  6 full cycles are usually given. </p><p>Authorised by Peter Ganly Pharmacist: Bevan Harden November 2012 D:\Docs\2018-04-19\0d852c7db864e360e834d3ba2a4e8bf9.docx Review September 2013 Canterbury Regional Cancer and Blood Service (Haematology) Page 3 of 5 Patient OSP Consultan Category: Group: t: Y J A P 1 2 3 4 NZMC O 1 3 Z 5 6 7 Reg. No: NHL cm Lymphob kg lastic m2 Lympho ma: Hyper- CVAD This alternate s with MTX Ara C</p><p>Day DTime Agent Do Route Instructions Doctor Nurse Start Stop a se t e 2 Ondansetron 8 mg PO Give 30-60 minutes prior to chemo T Cyclophospham mg IV In 100ml 0.9S over 2 hours Q12H 2 + ide 300mg/m</p><p>1</p><p>2</p><p> h</p><p>0.9% Sodium 100 ml IV For flushing Chloride 3 Ondansetron 8 mg PO Give 30-60 minutes prior to chemo Authorised by Peter Ganly Pharmacist: Bevan Harden November 2012 D:\Docs\2018-04-19\0d852c7db864e360e834d3ba2a4e8bf9.docx Review September 2013 Canterbury Regional Cancer and Blood Service (Haematology) Page 4 of 5 T Cyclophospham mg IV In 100ml 0.9S over 2 hours Q12H = 2 0 ide 300mg/m</p><p>0.9% Sodium 100 ml IV For flushing Chloride Ondansetron 8 mg PO Give 30-60 minutes prior to chemo T Cyclophospham mg IV In 100ml 0.9S over 2 hours Q12H 2 + ide 300mg/m</p><p>1</p><p>2</p><p> h</p><p>0.9% Sodium 10 ml IV For flushing Chloride 0 4 Vincristine mg IV In 50ml 0.9S free run over 10 mins 1.4mg/m2 0.9% Sodium 25 ml IV Flush and fast running saline Chloride 0 Doxorubicin mg IV Slow bolus into fast running 0.9S 50mg/m2 5 G-CSF 300 g SC 24 hours after chemotherapy completed until neuts > 1 X 109/L. Chart on QMR4 8 Cytarabine See intrathecal chemotherapy chart 100mg IT 11 Vincristine mg IV In 50ml 0.9S free run over 10 mins 1.4mg/m2 0.9% Sodium 100 ml IV For flushing Chloride 11-14 Dexamethasone 40 mg IV Chart on QMR4 or give OP Script (See above).</p><p>Authorised by Peter Ganly Pharmacist: Bevan Harden November 2012 D:\Docs\2018-04-19\0d852c7db864e360e834d3ba2a4e8bf9.docx Review September 2013 Canterbury Regional Cancer and Blood Service (Haematology) Page 5 of 5 daily for 4 days</p><p>Authorised by Peter Ganly Pharmacist: Bevan Harden November 2012 D:\Docs\2018-04-19\0d852c7db864e360e834d3ba2a4e8bf9.docx Review September 2013</p>