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23 Cards in this Set
- Front
- Back
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6 items that define a CR in AML
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1) no peripheral leukemia cells
2) PB ANC>1000 3) platelets >100 4) BM>20% cellularity w/ all lineages matured 5) BM<5% blasts (no Auer rods) 6) extramedullary leukemia not present |
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std induction regimen for AML
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7+3 regimen
daunorubicin 60-90mg/m2 x 3d/idarubicin 12mg/m2 x 3d + cytarabine 100-200mg/m2/d CI x7d |
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monitoring parameters for TLS
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1) increased UA
2) hyperphosphatemia, hyperkalemia, hypocalcemia 3) inc SCr, dec urine output, inc weight |
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2 drugs to eliminate UA
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allopurinol, rasburicase
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HD cytarabine dose/regimen for pts<60 yo with intermed or good risk cytogenetics
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3gm/m2 over 3hr Q12H d1,3,5 x 3-4 cycles
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MOA of ATRA
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causes proliferation of abnormal gene clone causing maturation, eventual terminal differentiation, and apoptosis
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characteristics of RAS (retinoic acid syndrome)
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fever, dyspnea, peripheral edema, serositis (pleural & pericardial effusions), hypotension, edema
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management of RAS (retinoic acid syndrome)
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dex 10mg IV q12h x 3 or more days ***continue ATRA unless severe sxs
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induction therapy for APL
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ATRA + idarubicin or daunorubicin
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post remission therapy for APL
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idarubicin or daunorubicin x 2 cycles + ATRA
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maint therapy for APL
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ATRA +/- 6MP + MTX x 1-2 yr
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alternative to anthracycline in APL with ATRA
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arsenic trioxide + ATRA
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complications of arsenic trioxide tx
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1) APL differentiation syndrome similar to RAS
2) cardiac tox 3) T-wave abnormalities 4) QTc prolongation 5) electrolyte mgmt (Ca,Mg,K) |
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typical daily IV dose of arsenic trioxide in APL
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0.15 mg/kg QD
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tx of relapsed APL w/ short remission (<1yr)
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arsenic trioxide, then auto SCT
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tx of relapsed APL w/ long remission (>1yr)
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arsenic trioxide or ATRA + anthracycline, then auto SCT
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gemtuzumab ozogamicin can be used for
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relapsed AML
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two "sanctuary sites" for ALL in body are
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CNS and testes
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3 chemotherapy regimens used in ALL
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1) Larsen regimen
2) BFM regimen 3) Hyper-CVAD |
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if ALL is Philadelphia chromosome positive, what 3 regimens
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1) imatinib + HyperCVAD
2) dasatanib + HyperCVAD 3) allo SCT |
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gemtuzumab ozogamicin indication
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CD33+ AML in 1st relapse, >=60yo, not candidates for cytotoxic chemo
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gemtuzumab dosing
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9mg/m2 q14d x 2
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gemtuzumab issues + toxicitues
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1) infusion reactions can occur 2-4hr after dose
2) extremely light sensitive tox=myelosuppression, neutropenia |
