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Table 4 Madison Wisconsin lymphoma protocol

From: Lansoprazole as a rescue agent in chemoresistant tumors: a phase I/II study in companion animals with spontaneously occurring tumors

Week 1:   Vincristine 0.7 mg/m2 IV
   Asparaginase 400 IU/kg IM
   Pre-med with chlorphenamine: small-medium 2.5-
   5 mg IM; medium-large 5-10 mg IM
   Prednisolone 2 mg/kg PO SID
  Start antacids: zantac 2 mg/kg PO BID
   antepsin < 20 kg 500 mg, > 20 kg 1-2 g PO TID
Week 2:   Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)
   Prednisolone 1.5 mg/kg PO SID
  Stop antacids: after week 2
Week 3:   Vincristine 0.7 mg/m2 IV
   Prednisolone 1 mg/kg PO SID
Week 4:   Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
   Pre-med with chlorphenamine and
   metoclopramide 0.5-1 mg/kg IM/SC)
   Prednisolone 0.5 mg/kg PO SID
Week 6:   Vincristine 0.7 mg/m2 IV
Week 7:   Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)
Week 8:   Vincristine 0.7 mg/m2 IV
Week 9:   Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
Pre-med with chlorphenamine + metoclopramide
Week 11:   Vincristine 0.7 mg/m2 IV
Week 13:   Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)
Week 15:   Vincristine 0.7 mg/m2 IV
Week 17:   Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
Pre-med with chlorphenamine + metoclopramide
Week 19:   Vincristine 0.7 mg/m2 IV
Week 21:   Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)
Week 23:   Vincristine 0.7 mg/m2 IV
Week 25:   Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
Pre-med with chlorphenamine + metoclopramide
  1. BLOODS:
  2. Haematology: prior to each dose
  3. Urine:- Dipstick after every cyclophosphamide dose
  4. - Full urinalysis after week 7
  5. CARDIAC SCAN:
  6. At time of: - First doxorubicin dose
  7. - Last doxorubicin dose
  8. - 3 months post protocol completion
  9. REPEAT VISITS:
  10. If in complete remission, checks should be made at months 1, 2, 3 and 6
  11. NOTES:
  12. • For dogs < 10 Kg, use a 1 mg/Kg dose of doxorubicin.
  13. • All treatment is discontinued after week 25 if in complete remission.
  14. • If neutrophil count is < 3 × 109/L wait 5-7 days and repeat haematology before giving chemo.
  15. If sterile haemorrhagic cystitis occurs on cyclophosphamide, discontinue and substitute Chlorambuci l (1.4 mg/kg PO) for subsequently scheduled cyclophosphamide injections.
  16. You can administer L-asparaginase (400 IU/kg IM) with each vincristine injection until CR is achieved.