Modified Magrath regimen of R-CODOX/R-IVAC
| Chemotherapy . | Day of administration . |
|---|---|
| R-CODOX | |
| Rituximab, 375 mg/m2 | D1* |
| Cyclophosphamide, 800 mg/m2 | D1, D2 |
| Doxorubicin, 50 mg/m2 | D1 |
| Vincristine, 1.4 mg/m2 (cap 2 mg) | D1, 15 |
| Peg-filgrastim, 6 mg | D3 |
| Methotrexate, 3000 mg/m2 | D15† |
| IT methotrexate, 12 mg/cytarabine, 50 mg | D1 |
| IT cytarabine, 50 mg | D3** |
| Patients with baseline CNS disease should receive in addition (cycle 1 only): | |
| IT cytarabine, 50 mg | D5 |
| IT methotrexate, 12 mg | D15 |
| R-IVAC | |
| Rituximab, 375 mg/m2 | D1 |
| Ifosfamide, 1500 mg/m2 (with MESNA) | D1-D5 |
| Etoposide, 60 mg/m2 | D1-D5 |
| Cytarabine, 2000 mg/m2 every 12 hours | D1-D2 |
| IT methotrexate, 12 mg | D5 |
| Peg-filgrastim | D6 |
| Patients with baseline CNS disease should receive in addition (cycle 1 only): | |
| IT cytarabine, 50 mg | D3 |
| IT methotrexate, 12 mg | D5 |
| Chemotherapy . | Day of administration . |
|---|---|
| R-CODOX | |
| Rituximab, 375 mg/m2 | D1* |
| Cyclophosphamide, 800 mg/m2 | D1, D2 |
| Doxorubicin, 50 mg/m2 | D1 |
| Vincristine, 1.4 mg/m2 (cap 2 mg) | D1, 15 |
| Peg-filgrastim, 6 mg | D3 |
| Methotrexate, 3000 mg/m2 | D15† |
| IT methotrexate, 12 mg/cytarabine, 50 mg | D1 |
| IT cytarabine, 50 mg | D3** |
| Patients with baseline CNS disease should receive in addition (cycle 1 only): | |
| IT cytarabine, 50 mg | D5 |
| IT methotrexate, 12 mg | D15 |
| R-IVAC | |
| Rituximab, 375 mg/m2 | D1 |
| Ifosfamide, 1500 mg/m2 (with MESNA) | D1-D5 |
| Etoposide, 60 mg/m2 | D1-D5 |
| Cytarabine, 2000 mg/m2 every 12 hours | D1-D2 |
| IT methotrexate, 12 mg | D5 |
| Peg-filgrastim | D6 |
| Patients with baseline CNS disease should receive in addition (cycle 1 only): | |
| IT cytarabine, 50 mg | D3 |
| IT methotrexate, 12 mg | D5 |
IVF, intravenous fluid; O, vincristine; Peg, pegylated.
During cycle 1, rituximab should be administered no earlier than day 3.
For high risk patients only.
Methotrexate is administered as a bolus over 2 to 4 hours once urine pH > 7. Leucovorin 200 mg/m2 IV given once 24 hours later and then 15 mg/m2 every 6 hours until level is <0.1. IVF with 3 amps of sodium bicarbonate should be administered until methotrexate has cleared.