TREANDA Rx

Indications for TREANDA:

Chronic lymphocytic leukemia (CLL). Indolent B-cell non-Hodgkin's lymphoma (NHL) that has progressed during or within 6 months of treatment with rituximab or a rituximab–containing regimen.

Adult Dose for TREANDA:

CLL: Give by IV infusion over 30 minutes. 100mg/m² on Days 1 and 2 of a 28-day cycle, up to 6 cycles. Hematologic toxicity (≥Grade 3): reduce dose to 50mg/m² on Days 1 and 2 of each cycle; if toxicity recurs, reduce dose to 25mg/m² on Days 1 and 2. Non-hematologic toxicity (clinically significant ≥Grade 3): reduce dose to 50mg/m² on Days 1 and 2 of each cycle. Subsequent cycles: may consider dose re-escalation. NHL: Give by IV infusion over 60 minutes. 120mg/m² on Days 1 and 2 of a 21-day cycle, up to 8 cycles. Hematologic toxicity (Grade 4) or non-hematologic toxicity (≥Grade 3): reduce dose to 90mg/m² on Days 1 and 2 of each cycle; if toxicity recurs, reduce dose to 60mg/m² on Days 1 and 2. Both: May give allopurinol prophylactically for those at high risk of tumor lysis syndrome. Delay treatment for Grade 4 hematologic toxicity or clinically significant ≥Grade 2 non-hematologic toxicity. Severe renal impairment (CrCl <40mL/min) or moderate to severe hepatic impairment: not recommended.

Children's Dose for TREANDA:

Not recommended.

Pharmacological Class:

Alkylating agent.

Warnings/Precautions:

Myelosuppression; monitor leukocytes, platelets, hemoglobin, neutrophils closely; restart treatment based on ANC and platelet count recovery. Renal or hepatic impairment. Monitor for infection, infusion or skin reactions, tumor lysis syndrome. Avoid extravasation. Pregnancy (Cat.D); avoid use. Nursing mothers: not recommended.

Interactions:

May be potentiated or antagonized by CYP1A2 inhibitors, inducers.

Adverse Reactions:

Lymphopenia, anemia, thrombocytopenia, leukopenia, neutropenia, pyrexia, nausea, vomiting, asthenia, fatigue, malaise, dry mouth, somnolence, cough, constipation, headache, mucosal inflammation, stomatitis, increased bilirubin, increased AST or ALT; infection, infusion reactions (discontinue if severe), tumor lysis syndrome, skin reactions (if severe or progressive, withhold dose or discontinue), other malignancies (eg, myelodysplastic syndrome, acute myeloid leukemia).

Metabolism:

Hepatic (CYP1A2). 94-96% protein bound.

Elimination:

Fecal (90%).

Generic Availability:

NO

How Supplied:

Single-use vial (25mg/8mL, 100mg/20mL)—1