Dexamethasone Cyclophosphamide

Aflatoxin Bl, bupropion, cyclophosphamide, dexamethasone, etoposide, ifosfamide, midazolam, phenobarbital, propofol, rifampin, teitiposide, thiotepa, vitamin D, xenobiotics Amitriptyhne, carisoprodol,... 

Noninterfering amitriptyline, carbamazepine, carmustine, chlorpromazine, cimeti-dine, cisplatin, cyclophosphamide, dexamethasone, diazepam, digoxin, etoposide, furo-semide, haloperidol, ibuprofen, imipramine, indomethacin, methotrexate, phenobarbi-tal, phen3doin, propranolol, ranitidine, theophylline, triazolam, warfarin... 

There are certain histologic subtypes of diffuse, aggressive NHL that respond less well to treatment with conventional regimens such as CHOP. Burkitt s lymphoma, lymphoblastic lymphoma, mantel cell lymphoma, and primary CNS lymphoma are examples of disease that benefit from more intensive therapy. Regimens such as hyper-CVAD, which alternate cycles of hyperfractionated cyclophosphamide, doxorubicin, vincristine, and dexamethasone with high-dose cytarabine and methotrexate, often are substituted for CHOP. Intrathecal therapy with methotrexate is indicated with documented CNS infiltration of tumor or involvement of the sinuses. The recent appreciation of the etiology of Helicobacter pylori in the etiology of peptic ulcer disease and the association between colonization and mucosal-associated lymphoma (MALT) has spurred... 

C, cytarabine ASP, asparaginase CALCB, Cancer and Leukemia Croup B CNS, central nervous system CTX, cyclophosphamide DEX, dexamethasone DNR, daunorubicin DOX, doxorubicin IT, intrathecal captopurine MTX, methotrexate PRED, prednisone TG, thioguanine VCR, vincristine. 

Moderate Anthracydine + cyclophosphamide SSRI (as above) and Dexamethasone 12 mg po (with aprepitant) and Aprepitant 125 mg po Aprepitant 80 mg po days 2 and 3... 

Taylor CW, Dalton WS, Mosley K, et al. Combination chemotherapy with cyclophosphamide, vincristine, adriamycin, and dexamethasone (CVAD) plus oral quinine and verapamil in patients with advanced breast cancer. Breast Cancer Res Treat 1997 42(1) 7-14. 

Plasmapheresis is effecdve in patients with severe neuropsychiatric SLE refractory to conventional treatment. Intrathecal methotrexate and dexamethasone is also beneficial to those patients (Dong et al., 2001 Baca et al., 1999). Positive results of a phase I/n trial of autologous hematopoietic stem cell transplantadon (AHSCT) at Northw estem University in Chicago, UL has led to a phase HI ASCT dial. As with other similar dials involving autoimmune disease, the ASCT dial is designed to include standard of care PV pulse cyclophosphamide (Burt et al., 2003b). 

Myeloma Melphalan (or cyclophosphamide) + prednisolone Vincristine + adriamycin + dexamethasone high dose mdphalan autograft... 

Interstitial pneumonitis has been reported in a 59-year-old man, who had taken amiodarone for 18 months, 18 days after a single dose of cyclophosphamide 1 year before he had also received six cycles of chemotherapy containing cyclophosphamide, vincristine, and prednisone, followed by four cycles of cisplatin, cytarabine, and dexamethasone (253). 

The incidence of deep venous thrombosis is increased by the co-administration of doxorubicin, as suggested by a study in 232 patients with multiple myeloma who received a combination of thahdomide and chemotherapy in two protocols that differed only by the inclusion of doxorubicin in one DT-PACE (dexamethasone -I- thahdomide -I-cisplatin -I- doxorubicin + cyclophosphamide -I- etoposide) and DCEP-T (dexamethasone + cyclophosphamide -I-etoposide -I- cisplatin + thalidomide) (25). There was an increased risk of deep venous thrombosis in those who received DT-PACE but not in those who received DCEP-T. Multivariate analysis confirmed that those who received thahdomide + doxorubicin had an increased risk of deep venous thrombosis. In two separate trials in patients taking thahdomide for multiple myeloma, deep venous thrombosis occurred in four of 15 patients who received concomitant treatment with doxorubicin -I- dexamethasone compared with three of 45 who received dexamethasone only (26). 

Recommendation 4. For the prevention of delayed emesis after cisplatin therapy in adults, dexamethasone with metoclopramide or a SSRI is recommended. Thechoice of agent should be based on patient-specific factors and cost. For delayed emesis after cyclophosphamide, doxorubicin, or carboplatin therapy, a SSRI with dexamethasone is recommended. In pediatric patients, chlorpromazine, lorazepam, or a SSRI can be used in combination with a corticosteroid. 

When used in combination with corticosteroids, cyclophosphamide is dosed at 1-3 mg/kg for oral therapy and 0.5-1.0 g/m of body surface area for intravenous therapy. The most common route of cyclophosphamide administration is intravenous, although there is little evidence that this is better than oral administration. Likewise, there is no evidence to suggest the optimal duration of treatment. Based on empirical experience, cyclophosphamide generally is dosed monthly for 6 months and then every 3 months for a period of either 2 years or for 1 year after the nephritis is in remission." " Of course, cyclophosphamide therapy is not without risk. Serious toxic effects include suppression of hematopoiesis, opportunistic infections, bladder complications (e.g., hemorrhagic cystitis and cancer), sterility, and teratogenesis. White blood cell counts must be monitored during cyclophosphamide therapy, and if the nadir is less than 1500/mm, the dose must be adjusted to keep the white cell count above 1500/mm. Nausea and vomiting associated with cyclophosphamide can be controlled with oral ondansetron plus dexamethasone. ... 

MACOP-B methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin MALT mucosa-associated lymphoid tissue M-BACOD methotrexate, bleomycin, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), and dexamethasone MCL mantle cell lymphoma... 

HLA human leukocyte antigen HSCT hematopoietic stem cell transplantation hyper-CVAD high-dose methotrexate and cytarabine alternating with fractionated cyclophosphamide plus vincristine, doxorubicin, and dexamethasone IBMTR International Bone Marrow Transplant Registry IL-2 interleukin-2 MDS myelodysplastic syndrome MLL mixed lineage leukemia MUD matched unrelated donor NCCN National Comprehensive Cancer Network NST nonmyeloablative stem cell transplant OS overall survival Ph+ Philadelphia chromosome PML promyelocytic leukemia (gene)... 

A = Adults C = children MTX = methotrexate MP cyclophosphamide Dexa = dexamethasone. 

Figure 9.1-3 Key in utero immune maturation events and toxicant disruption. Seven in utero critical immune maturation events in the rodent are shown with developmental immunotoxicants known to disrupt those processes. In some cases, the processes are blocked by the xenobiotics while in others the integrity of the process may be compromised by early-life exposure. Arrows are not designed to indicate precise in utero timing but rather general periods of prenatal development. CsA = cyclosporin A CY = cyclophosphamide DEX = dexamethasone EPS = lipopolysaccharide. Adapted from Dietert and Piepenbrink (2006a).

CYP2A6 <5 1-2 Acetaminophen Carbamazepi ne Cyclophosphamide Selegiline Flunitrazepam Nicotine Clotrimazole Isoniazid Methoxypsoralen Valproic acid Dexamethasone Phenobarbital Rifampin... 

In addition to the drugs mentioned above (doxorubicin, 5-fluoruracil, methotrexate, and cyclophosphamide), researchers have found other chemotherapy compounds to be common in studies that looked at problems with language, memory, and other cognitive abilities. These drugs include cisplatin, vincristine, etoposide, vinblastine, and steroids such as dexamethasone and prednisone. Their relative risks associated with later cognitive impairment, however, have not been well established. 

There is limited and conflicting evidence on the effect of prednisone and prednisolone on the metabolic activation of cyclophosphamide. Synergistic increases in enzyme induction may occur if cyclophosphamide is given with dexamethasone. Dexamethasone does not appear to alter ifosfamide metabolism. 

The documentation is very limited. It appears that dexamethasone does not have any appreciable effeet on the metabolism of ifosfamide. The information on cyclophosphamide is eonflicting, and the elinieal importanee of any changes remains to be established. However, it should be noted that... 

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