(BQ) Part 2 book “Practical chemotherapy - A multidisciplinary guide” has contents: Fludarabine oral, gemcitabine, liposomal daunorubicin, liposomal doxorubicin, mayo regimen, rituximab, prednisolone, mitoxantrone, cyclophosphamide, etoposide, bleomycin, vincristine, and other contents. | FMD (fludarabme, mitoxantroiie* dexamethasoite}, also known as FND (fiudarabine, . Novantrcme®, dexamethasone) and FMP (fludarabine, mitoxaittroite, prednisolone) USUAL INDICATION Relapsed low-grade lymphoma. DOSES FMD Fludarabine 25 mg/m2 IV* on days 1-3 Mitoxantrone 10 mg/m2 IV on day I Dexamethasone 20 mg (total dose) IV or by mouth on days 1-5 FMP Fludarabine 25 mg/m2 IV* on days 1—3 Mitoxantrone 10 mg/m2 IV on day 1 Prednisolone' 40mg (total dose) by mouth on days 1—5 ADMINISTRATION Fludarabine is administered by IV bolus or short IV infusion, and mitoxantrone is administered as a slow IV bolus into a free-running saline infusion. The order of administration of IV drugs is not critical. Dexamethasone (FMD) is administered as a slow IV bolus (over a period of 4-5 min - rapid administration leads to histamine release, which causes perineal discomfort) or by mouth (oral administration should be used if possible), and prednisolone (FMP) is administered by mouth. Mitoxantrone can cause tissue necrosis following extravasation, and should be administered with appropriate precautions to prevent this from occurring. If there is any possibility that extravasation has occurred, contact a senior member of the medical team immediately and follow local procedures for dealing with extravasation incidents. * Published studies were conducted before fludarabine tablets became available. However, it is reasonable to suppose that oral fludarabine at a dose of 40 mg/m 2 /day could be substituted for IV fludarabine on days 1-3. Oral fludarabine at this dose has been shown to be equivalent to IV fludarabine 25 mg/m2 in other situations (see chapter on fludarabine monotherapy). t Published studies have used IV prednisone. This is not available in the UK. Oral prednisolone is often used as a substitute without any requirement for dose adjustment. 188 V FMD ANTI-EMETICS Low emetogenic potential (see local policy). Note that the steroids included in the regimen will have a .
