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PROTOCOLS USED AT SOUTHEND AND BASILDON IN THE TREATMENT OF HAEMATOLOGICAL CANCER |
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DISEASE |
REGIMEN/DRUGS |
SOURCE |
COMMENTS |
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NON HODGKINS’ LYMPHOMA (HIGH GRADE LYMPHOMA) |
PACE-BOM |
BNLI |
Standard schedule for high grade lymphoma |
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PACE-BO |
BNLI |
Slightly less intensive (mainly for the elderly) |
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PMitCE-BO |
BNLI |
In context of randomized trial, or if cardiac impairment |
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EPIC/ESHAP/COPX |
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Salvage schedule for patients who relapse |
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CHOP |
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NON-HODGKINS’ LYMPHOMA (LOW GRADE) |
Chlorambucil and Prednisolone |
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This is standard treatment. |
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FLUDARABINE/FAD/ |
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Salvage treatment. |
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HODGKINS’ DISEASE |
Pabloe/CHlvpp |
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Alternating is current standard schedule |
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LOPP |
BNLI |
Occasionally |
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EVAP |
BNLI |
Occasionally |
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ABVD/VAPEC |
BNLI |
Occasionally |
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EPIC |
Royal Marsden |
Salvage schedule as above |
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MYELOMA |
Study 9401 - high does Melphalan vs intermediate dose |
Southern England Coll Trials Group |
Patients over 65 years and/or clinically unfit would have conventional treatment - Melphalan and Prednisolone or weekly Cyclophosphamide or MRC VIII (ABCM X 6 vs ABCM X 8) |
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Myeloma VIII |
Southern England Coll Trials Group |
Patients under 65 years would have VAMP induction followed by further intensive treatment using MRC or MRC type or Southend England protocol treatment and PBSCT |
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CIDEX |
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For Relapsed/Refractory Myeloma in the Elderly |
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DISEASE |
REGIMEN/DRUGS |
SOURCE |
COMMENTS |
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ACUTE MYELOID LEUKAEMIA |
Royal London Protocol |
RLH |
Protocols used in care of AML will be reviewed annually with emerging evidence/statistics. |
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ACUTE LYMPHATIC LEUKAEMIA (ADULT) |
Royal London Protocol 07/93 ‘Anglo/Italian’ |
RLH |
Phase 2 - Observational protocol, more suitable in terms of survival figures and toxicity. Reviewed annually with emerging evidence/statistics. |
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UKALL XIIa |
MRC |
Very intensive with high toxicity/morbidity |
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CHRONIC MYELOID LEUKAEMIA |
CMLV |
MRC |
Low-dose Interferon ((+/- Hydroxyurea) versus High-dose Interferon (+/- Hydroxyurea) |
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CHRONIC LYMPHATIC LEUKAEMIA |
CLL (Pilot study) |
MRC |
Fludarabine with autologous bone marrow or PBST in younger patients with CLL |
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CLL 4 |
MRC |
Chlorambucil vs Fludarabine vs Flurdarabine & Cyclophosphamide |
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HAIRY CELL LEUKAEMIA |
2 CDA or DCF* |
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First line treatment (choice depends on age and fitness) |
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Interferon |
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Second line treatment (choice depends on age and fitness) |
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MYELODYSPLASTIC SYNDROME |
Standard treatment includes |
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Patient receives generally supportive care. Various protocols are under active consideration with the Royal London Hospital |
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T-CELL LYMPHOMA (Cutaneous) |
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Under review within Skin Cancer Working Group |
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CHRONIC PROLYMPHOCYTIC LEUKAEMIA |
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Very rare condition. No standard protocol available. |
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MYELOPROLIFERATIVE DISORDERS - PRV |
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No standard protocol but established treatments include Interferon (for young age groups), Hydroxyurea or P32. |
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ET |
PTI |
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Aspirin vs Hydroxyurea vs Anagrelide |
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*2CDA - Chlordeoxyadenosine |
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