Table 1. Dose-adjusted EPOCH Drug . Dose... | American Society of Hematology

Table 1.

Dose-adjusted EPOCH

Drug	Dose	Route	Treatment days
Infused agents*
Etoposide	50 mg/m²/day	CIV	1,2,3,4 (96 hours)
Doxorubicin	10 mg/m²/day	CIV	1,2,3,4 (96 hours)
Vincristine†	0.4 mg/m²/day	CIV	1,2,3,4 (96 hours)
Bolus agents
Cyclophosphamide (cycle 1)
CD4⁺ cells ≥ 100/mm³	375 mg/m²/day	IV	5
CD4⁺ cells < 100/mm³	187 mg/m²/day	IV	5
Cyclophosphamide dose-adjustment (after cycle 1)‡
nadir ANC > 500/μL	↑ 187 mg above previous cycle	—	—
nadir ANC < 500/μL or platelets < 25 000/μL	↓ 187 mg below previous cycle	—	—
Prednisone	60 mg/m²/day	PO	1,2,3,4,5
Filgrastim	5 μg/kg/day	SC	6 → ANC > 5000/μL (past nadir)
Next cycle§			Day 21

Drug	Dose	Route	Treatment days
Infused agents*
Etoposide	50 mg/m²/day	CIV	1,2,3,4 (96 hours)
Doxorubicin	10 mg/m²/day	CIV	1,2,3,4 (96 hours)
Vincristine†	0.4 mg/m²/day	CIV	1,2,3,4 (96 hours)
Bolus agents
Cyclophosphamide (cycle 1)
CD4⁺ cells ≥ 100/mm³	375 mg/m²/day	IV	5
CD4⁺ cells < 100/mm³	187 mg/m²/day	IV	5
Cyclophosphamide dose-adjustment (after cycle 1)‡
nadir ANC > 500/μL	↑ 187 mg above previous cycle	—	—
nadir ANC < 500/μL or platelets < 25 000/μL	↓ 187 mg below previous cycle	—	—
Prednisone	60 mg/m²/day	PO	1,2,3,4,5
Filgrastim	5 μg/kg/day	SC	6 → ANC > 5000/μL (past nadir)
Next cycle§			Day 21

Data are for cycle 1, except where noted in “Cyclophosphamide dose-adjustment.” — represents not applicable.

Etoposide, doxorubicin, and vincristine can be admixed in the same solution. Etoposide, doxorubicin, and vincristine are never dose-adjusted for hematologic toxicity.

†

Vincristine dose should never be routinely capped.

‡

Dose based on previous cycle absolute neutrophil count (ANC) nadir (CBC BIW); maximum cyclophosphamide dose 750 mg/m².

Begin day 21 if ANC ≥ 1000/μL and platelets ≥ 50 000/μL.

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