Indications & Dose: CHILDHOOD RHABDOMYOSARCOMA Combination therapy IV Adult 15µg/kg/day as inf over 10-15min 5 days Child >6 month: Same as adult dose | EWING’S SARCOMA Combination therapy IV Adult 15µg/kg/day as inf over 10-15min 5 days Child >6 month: Same as adult dose | GESTATIONAL TROPHOBLASTIC NEOPLASM Combination therapy IV Adult 500µg/dose over 10-15mins on days 1 & 2 | Mono therapy IV Adult 12µg/kg/day 5 days | TESTICULAR CANCER Combination therapy IV Adult 1000µg/m2 on day 1 with cyclophosphamide, bleomycin, vinblastin & cisplatin | WILMS’ TUMOR Combination therapy IV Adult 15µg/kg/day as inf over 10-15min 5 days Child >6 month: Same as adult dose

Precautions: Elderly, children <4 yr, patients who have received radiation therapy, debilitated patients, depressed bone marrow from radiotherapy/therapy with other anti-neoplastics

ADR: Serious: growth retardation, hyperuricemia, GI ulceration, blood disorders, ascites, hepatitis/hepatic failure, abnormal renal function, anaphylactoid reaction, infect, Others: pneumonitis, erythema, edema, myalgia, mucositis, nausea, pharyngitis, vomiting, abdominal pain, diarrhea, dysphagia, esophagitis, Fatigue, fever, lethargy, acne, alopecia, cheilitis, increased pigmentation, skin eruptions

DDI: Serious Vaccines (Live) generalized infect may occur

Monitor: CBC with differential & platelet count, LFTs, renal function tests, monitor for signs/symptoms of hepatic VOD, including unexplained weight gain, ascites, hepatomegaly/unexplained right upper quadrant pain