Leukemias, lymphomas, and other hematologic cancers:
Indications for: MATULANE
Stage III and IV Hodgkin's disease as part of the MOPP (nitrogen mustard, vincristine, procarbazine, prednisone) regimen.
Initially 2–4mg/kg per day for the first week, then 4–6mg/kg per day until max response is obtained or until WBCs <4,000cells/mm3 or platelets <100,000cells/mm3. Maintain at 1–2mg/kg per day once max response attained. In MOPP regimen: 100mg/m2 daily for 14 days.
Individualize. Initially 50mg/m2 per day for the first week, then 100mg/m2 per day until max response is obtained or leukopenia or thrombocytopenia occurs. Maintain at 50mg/m2 per day once max response attained.
Inadequate marrow reserve.
Discontinue if CNS effects (eg, paresthesias, neuropathies, confusion), leukopenia, thrombocytopenia, hypersensitivity reactions, stomatitis, diarrhea, hemorrhage or bleeding tendencies occur. Hepatic or renal impairment. Obtain baseline CBCs with differential, hemoglobin, hematocrit, reticulocytes, platelets prior to therapy, then monitor at least every 3–4 days. Do renal and hepatic function tests before starting therapy, then repeated weekly. Pregnancy (Cat.D); avoid use. Nursing mothers: not recommended.
Avoid sympathomimetics, tricyclic antidepressants (eg, amitriptyline, imipramine), foods with high tyramine content (eg, wine, yogurt, ripe cheese, bananas). CNS depression with barbiturates, antihistamines, narcotics, hypotensive agents, phenothiazines. Disulfiram-like reactions with alcohol. Separate radiation or other myelosuppressives by at least 1 month (allow for bone marrow recovery).
Leukopenia, anemia, thrombopenia, GI upset, bleeding tendencies, CNS effects, dysphagia, anorexia, abdominal pain, hypotension, tachycardia, syncope, cough, alopecia, dermatitis, pain, others.