Indications & Dose: ACUTE LYMPHOCYTIC LEUKEMIA Combination therapy IV Adult Remission induction: 45mg/m2/day for 3 days Child Remission induction: >2 yr BSA >0.5m2: 25mg/m2/on day 1 qwk for upto 4-6 cycles | ACUTE MYELOID LEUKEMIA Combination therapy IV Adult <60 yr: 45mg/m2/day for 3 days of the first course of induction therapy, subsequent courses 45mg/m2/day for 2 days. Note: Cumulative dose in adults: Should not exceed 550mg/m2 & 400mg/m2 without risk factors for cardiotoxicity & chest irradiation, >60 yr: 30mg/m2/day for 3 days of the first course of induction therapy, subsequent courses 30mg/m2/day for 2 days Child >2 yr & BSA >0.5m2: 30-60mg/m2/day as continuous inf on days 1-3 of cycle. Note: Should not exceed 10mg/kg if <2 yr or 300mg/m2 if >2 yr

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

ADR: Serious: Transient ECG abnormalities, S-T wave changes, myelosuppression, blood disorders, skin flare at Inj site, hyperuricemia, GI ulceration, Others: diarrhea, abdominal pain, alopecia, nausea, vomiting, stomatitis, discoloration of urine/saliva/sweat/tears

DDI: Serious Ciclosporin increases drug level

Monitor: CBC with differential & platelet count, LFTs, ECG, left ventricular ejection function (echocardiography/multigated radionuclide angiography scan), renal function test