Table 1 Dose-modified CODOX-M regimen,... | American Society of Hematology

Table 1

Dose-modified CODOX-M regimen, with further modification for age older than 65

Day	Drug	Dose	Method	Time
1	Cyclophosphamide	800 mg/m²	IV
	Vincristine	1.5 mg/m² (max 2 mg)	IV
	Doxorubicin	40 mg/m²	IV
	Cytarabine	70 mg	IT
2 to 5	Cyclophosphamide	200 mg/m²	IV	Daily
3	Cytarabine	70 mg	IT
8	Vincristine	1.5 mg/m²	IV
10	Age 65 y or younger
	Methotrexate	300 mg/m²	IV	1 h
	Methotrexate	2700 mg/m²	IV	Given over next 23 h
	Age more than 65 y
	Methotrexate	100 mg/m²	IV	1 h
	Methotrexate	900 mg/m²	IV	Given over next 23 h
11	Leucovorin	15 mg/m²	IV	At h 36 from start of IV methotrexate
		15 mg/m²	IV	Every 3 h between 36-48 h
		15 mg/m²	IV	Then every 6 h until methotrexate level is < 5× 10⁻⁸ M
13	G-CSF	5 μg/kg (1 ampoule)	SC	Daily until granulocyte count > 1×10⁹/L then discontinue
15	Methotrexate	12 mg	IT
16	Leucovorin	15 mg	PO	24 h after IT methotrexate

Day	Drug	Dose	Method	Time
1	Cyclophosphamide	800 mg/m²	IV
	Vincristine	1.5 mg/m² (max 2 mg)	IV
	Doxorubicin	40 mg/m²	IV
	Cytarabine	70 mg	IT
2 to 5	Cyclophosphamide	200 mg/m²	IV	Daily
3	Cytarabine	70 mg	IT
8	Vincristine	1.5 mg/m²	IV
10	Age 65 y or younger
	Methotrexate	300 mg/m²	IV	1 h
	Methotrexate	2700 mg/m²	IV	Given over next 23 h
	Age more than 65 y
	Methotrexate	100 mg/m²	IV	1 h
	Methotrexate	900 mg/m²	IV	Given over next 23 h
11	Leucovorin	15 mg/m²	IV	At h 36 from start of IV methotrexate
		15 mg/m²	IV	Every 3 h between 36-48 h
		15 mg/m²	IV	Then every 6 h until methotrexate level is < 5× 10⁻⁸ M
13	G-CSF	5 μg/kg (1 ampoule)	SC	Daily until granulocyte count > 1×10⁹/L then discontinue
15	Methotrexate	12 mg	IT
16	Leucovorin	15 mg	PO	24 h after IT methotrexate

Next cycle on the day that the unsupported absolute granulocyte count is more than 1.0 × 10⁹/L, with an unsupported platelet count of more than 75 × 10⁹/L.

IV indicates intravenous; IT, intrathecal; SC, subcutaneous; and PO, oral.

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