FBC and blood film. Renal/liver/bone panel, LDH, CRP, uric ...

1 Low dose ara-c Version Page 1 of 2 1 Acute Myeloid Leukaemia Low Dose Cytarabine Indication Non-Intensive Chemotherapy. Pre-treatment Evaluation BMA(T) clinical decision. FBC and blood film. Renal/liver/bone panel, LDH, CRP, uric acid, serum glucose. Drug Regimen (OPCS code: ) Days Drug Dose Administration D1-10 (20doses) Cytarabine 20mg SC 12-hourly by subcutaneous injection Considerations: in patients with liver function tests greater than twice the upper limit of normal clinical decision. may be given with or without Gemtazumab Ozogamicin (5mg) on day 1 of each of the first 4courses.

2 See Gemtazumab protocol. Cycle Frequency Repeat every 28 to 42 days. Dose Modifications No information Investigations prior to subsequent cycles No information Treatment Duration In some patients it may be necessary to extend the intervals to up to 42 days. A minimum of 4 courses should be administered. If it is considered appropriate, further courses can be administered (with no limit to the number given). Concurrent Medication low dose ara-c Version Page 2 of 2 Adequate hydration. Allopurinol daily clinical decision. Anti-ulcer drug as per local policy. Antimicrobial and antifungal prophylaxis as per local protocol.

3 Anti-emetics low emetogenic protocol Regular antiemetics may not be needed but if required Pre-Chemo Metoclopramide 10mg IV STAT or Domperidone 20mg PO Post-Chemo Regular or PRN Metoclopramide 20mg TDS PO or Domperidone 20mg TDS PO Adverse effects At doses prescribed here adverse reactions are unusual. For higher doses, adverse effects include nausea, diarrhoea, oral ulceration and hepatic dysfunction. References AML 14 MRC Protocol (January 2005) WLCN. Treatment of Chemotherapy induced nausea and vomiting prescribing guidelines. May 2002. Patient information Leukaemia Research Fund - Adult Acute Myeloid Leukaemia booklet CancerBACUP - Acute myeloid leukaemia booklet Cancer BACUP fact file patient drug information leaflets low dose ara-c Version Page 3 of 2 Written by: Ish Patel, Nicki Panoskaltsis, Eduardo Olavarria Authorised by: WLCN haematology TWG Date for review by haematology TWG: September 2007