HYPER CVAD PROTOCOL PDF

Patients with lymphoma should be considered for inclusion into clinical trials. Pegfilgrastim: PBS authority. All other drugs in this protocol with the exception of oral mesna are on the PBS general schedule. The cost displayed on the protocol is intended as rudimentary guide only for the Australian context. The cost includes antineoplastic drugs only not antiemetics, supportive medications or consumables , unless otherwise indicated. These costs are reviewed and updated on eviQ at 6 monthly intervals.

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Hyper is short for hyperfractionated. It means you are given more than one treatment of the same drug in a day. CVAD stands for the initials of some of the drugs used. But most people call it hyper-CVAD. Your doctor will talk to you about this treatment and its possible side effects before you agree consent to have treatment. You will be given hyper-CVAD during a stay in hospital or in the chemotherapy day unit. A chemotherapy nurse will give it to you.

During treatment, you usually see a cancer doctor, a blood specialist haematologist , a chemo-therapy nurse or a specialist nurse and a specialist pharmacist. This is who we mean when we mention doctor or nurse in this information. Before or on the day of treatment, a nurse or person trained to take blood phlebotomist will take a blood sample from you. This is to check that your blood cells are at a safe level to have chemotherapy. You will see a doctor or nurse before you have chemotherapy.

They will ask you how you have been feeling. If your blood results are okay, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready. Sometimes methotrexate and cytarabine are given by injection into the fluid around the spinal cord intrathecally. You have chemotherapy as a course of several sessions cycles of treatment over a few months.

You will have each schedule four times in a pattern of A then B. Each cycle of hyper-CVAD lasts 21 days. But if you have hyper-CVAD before a stem cell transplant , you usually only have 2 cycles of each schedule.

Day 1 — your nurse gives you 2 separate drips of cyclophosphamide. The second drip is given 12 hours after the first. You will have fluids through a drip before and after cyclophosphamide. Day 2 — you have 2 drips of cyclophosphamide again.

They are given 12 hours apart. Day 4 — you have vincristine and doxorubicin as a drip. You can usually go home the day after it finishes. Day 11 — you have vincristine again, usually in the chemotherapy day unit.

You also start taking dexamethasone tablets for 4 days days 11 to Days 15 to 21 — you do not have any treatment. This is the last week in the cycle. Your next cycle will be Schedule B.

This helps to reduce the side effects of methotrexate. You have it regularly until the methotrexate is out of your system. You also have 2 drips of cytarabine.

Day 3 — you have 2 more drips of cytarabine. You can usually go home after this if your methotrexate levels are okay. Days 4 to 21 — you do not have any treatment.

This completes the cycle of hyper-CVAD. Your next cycle will be schedule A again. Some people have methotrexate and cytarabine given into the spinal fluid.

This is called intrathecal chemotherapy. Your cancer doctor or nurse will tell you more about this. You usually have it on different days from the rest of your chemotherapy treatment.

The doctor numbs an area of skin over your spine with local anaesthetic. They gently insert a needle between two of the spinal bones. This is called a lumbar puncture. They inject the chemotherapy drug through this needle into the spinal fluid. Before you go home, the nurse or pharmacist will give you anti-sickness drugs to take. You may also be given other drugs to take, for example to help reduce your risk of getting an infection. Take all your tablets exactly as they have explained to you.

We explain the most common side effects of this treatment here. We also include some less common side effects. You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have. Your doctor can give you drugs to help control some side effects.

It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve. Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you. Your nurse will give you telephone numbers for the hospital.

If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe. We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium eMC for more detailed information. Your nurse will check you for signs of a reaction during your treatment.

If you feel unwell or have any of these signs, tell them straight away. If you do have a reaction, it can be treated quickly. Sometimes a reaction can happen up to 24 hours after treatment. If you get any signs or feel unwell after you get home, contact the hospital straight away. If the drug leaks outside the vein, it can damage the surrounding tissue. This is called extravasation. Extravasation is not common but if it happens it is important to treat it quickly.

Tell your nurse straight away if you have any stinging, pain, redness or swelling around the vein. If you get any of these symptoms after you get home, contact the doctor or nurse straight away on the contact telephone number they gave you. You may suddenly feel warm and your face may get red while the drug is being given. This should only last a few minutes.

Some people may have hot flushes, a feeling of having a blocked nose and a strange taste in their mouth when cyclophosphamide is given. This does not last for long. But if you notice this, tell your nurse. They can give the treatment more slowly, which will reduce these symptoms. This treatment can reduce the number of white blood cells in your blood.

These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia. If you have an infection, it is important to treat it as soon as possible. Contact the hospital straight away on the hour contact number you have if:. It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time. G-CSF granulocyte-colony stimulating factor is a type of drug called a growth factor.

It encourages the body to make more white blood cells. This treatment can reduce the number of platelets in your blood.

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Acronym: Hyper-CVAD

Patients with lymphoma should be considered for inclusion into clinical trials. Specific evidence is not cited for use in other aggressive lymphomas, and use of Hyper-CVAD will be at the physician's discretion in most cases. The evidence for this regimen in the treatment of MCL comes from three prospective trials:. The addition of rituximab to chemotherapy has shown to be beneficial with a meta-analysis r of rituximab plus chemotherapy for patients with indolent NHL or MCL finding those treated with rituximab plus chemotherapy had superior overall survival, response and disease control than those that were treated with chemotherapy alone. However, only three small studies for MCL were available for inclusion. Overall survival r. Flinders Filters has partnered with eviQ to build reliable, robust search filters to retrieve core high level evidence on topics of significance to eviQ.

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Non-Hodgkin lymphoma hyper CVAD Part A and B treatment overview

Hyper-CVAD is a chemotherapy regimen used to treat some forms of leukemia , non-Hodgkin lymphoma high grade and lymphoblastic leukemia. The term 'hyper' refers to the hyperfractionated nature of the chemotherapy, which is given in smaller doses, more frequently, to minimize side effects. Course B consists of methotrexate and cytarabine. The protocol was originally developed to treat leukemia in young, fit patients, due to its intensity, but has since begun to be used more widely.

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Non-Hodgkin lymphoma hyper CVAD part A

Hyper is short for hyperfractionated. It means you are given more than one treatment of the same drug in a day. CVAD stands for the initials of some of the drugs used. But most people call it hyper-CVAD. Your doctor will talk to you about this treatment and its possible side effects before you agree consent to have treatment. You will be given hyper-CVAD during a stay in hospital or in the chemotherapy day unit. A chemotherapy nurse will give it to you.

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