Indications & Dose: ACUTE LYMPHOCYTIC LEUKEMIA IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | BLADDER CANCER IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | BREAST CANCER IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | HODGKIN’S DISEASE IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | MALIGNANT LYMPHOMAS IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | NEUROBLASTOMA IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | OVARIAN CANCER IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | SMALL-CELL LUNG CANCER IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | SOFT TISSUE & BONE SARCOMA IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | STOMACH CANCER IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | THYROID CANCER IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks | WILMS’ TUMOR IV Adult 60-75mg/m2/dose over 3-5min q3wk or 60mg/m2/dose over 3-5min q2wk or 40-60 mg/m2/dose over 3-5min q3-4wk or 20-30mg/m2/day over 3-5min 2-3 days q4wk or 20mg/m2/dose over 3-5min q1wk Child 35-75mg/m2/dose over 3-5min q3wk or 20-30mg/m2/dose over 3-5min q1wk or 60-90mg/m2/dose as continuous inf over 96h q3-4wks

Precautions: Pre-existing CVD, HTN, concurrent administration of other antineoplastic agents, prior/concurrent chest irradiation, elderly, infants & children, debilitated patients, depressed bone marrow from radiotherapy/therapy with other anti-neoplastics, hepatobiliary dysfunction, patients who have received radiation therapy

ADR: Serious: Acute cardiotoxicity, AV block, bradycardia, extrasystoles, sinus tachycardia, ST-T wave changes, supraventricular tachycardia, CHF, myocarditis, pericarditis, hyperuricemia, colon necrosis, GI ulceration, blood disorder, Others: skin flare at Inj site, weakness, nausea, vomiting, diarrhea, abdominal pain, Malaise, alopecia, itching, photosensitivity, rash, discoloration of urine/saliva/sweat/tears, amenorrhea

DDI: Serious Ciclosporin (high-dose) increases drug level & causes myelotoxicity of drug, Warfarin effects increase by drug, Verapamil/Sorafenib increases drug level, Mitomycin increases the incidence of cardiotoxicity, Thalidomide increases the risk of deep-vein thrombosis in patients with multiple myeloma, Paclitaxel leads to cardiotoxicity, Isoflurane may prolong QT interval, Barbiturates reduces drug effects

Diet:

Monitor: CBC with differential & platelet count, LFTs, serum uric acid, calcium, potassium, phosphate & creatinine, cardiac function, ECG, left ventricular ejection fraction (echocardiography/multigated radionuclide angiography)