Canterbury DHB (Haematology) / Page 1 of 7
SCT Conditioning –
Fludarabine, cytarabine, Amsacrine, and
IV Busulphan / Height / cm
Weight / kg
BSA / m2
Destination / Hypersensitivities/Allergies
PRN antiemetics
Domperidone 10-20mg PO QID
 Cyclizine 50mg TDS PO/IV
 Lorazepam 2mg PO PRN
 Scopolamine patch, change every 3rd day / Agent
Fludarabine
Cytarabine
Amsacrine
Busulphan
DOSE MODIFIED:NoYes / Round
6mg (vial size)
Reference: AML 17 protocol Version 9.0 May 2013
Day / Date / Time / Agent / Dose / Route / Instructions / Doctor / Nurse / Check / Start / Stop
-12 / Ondansetron / 8 / mg / PO
Dexamethasone / 12 / mg / PO
Fludarabine 30mg/m2 / mg / IV / In 100mL 0.9% saline over 30 minutes
Cytarabine 2000mg/m2 / mg / IV / In 500mL 0.9% saline over 2 hours
Amsacrine 100mg/m2 / mg / IV / In 500mL 5% dextrose over 1 hour
Ondansetron / 8 / mg / PO
-11 / Ondansetron / 8 / mg / PO
Dexamethasone / 12 / mg / PO
Fludarabine 30mg/m2 / mg / IV / In 100mL 0.9% saline over 30 minutes
Cytarabine 2000mg/m2 / mg / IV / In 500mL 0.9% saline over 2 hours
Amsacrine 100mg/m2 / mg / IV / In 500mL 5% dextrose over 1 hour
Ondansetron / 8 / mg / PO
Patient Category:
Y J A P O 1 3 Z / OSP Group:
1 2 3 4 5 6 7 / Consultant:
NZMC Reg. No:
SCT Conditioning -
Fludarabine, cytarabine, Amsacrine, and
IV Busulphan / Height / cm
Weight / kg
BSA / m2
Day / Date / Time / Agent / Dose / Route / Instructions / Doctor / Nurse / Check / Start / Stop
-10 / Ondansetron / 8 / mg / PO
Dexamethasone / 12 / mg / PO
Fludarabine 30mg/m2 / mg / IV / In 100mL 0.9% saline over 30 minutes
Cytarabine 2000mg/m2 / mg / IV / In 500mL 0.9% saline over 2 hours
Amsacrine 100mg/m2 / mg / IV / In 500mL 5% dextrose over 1 hour
Ondansetron / 8 / mg / PO
-9 / Ondansetron / 8 / mg / PO
Dexamethasone / 12 / mg / PO
Fludarabine 30mg/m2 / mg / IV / In 100mL 0.9% saline over 30 minutes
Cytarabine 2000mg/m2 / mg / IV / In 500mL 0.9% saline over 2 hours
Amsacrine 100mg/m2 / mg / IV / In 500mL 5% dextrose over 1 hour
Ondansetron / 8 / mg / PO
-8 / Ondansetron / 8 / mg / PO
Dexamethasone / 12 / mg / PO
Ondansetron / 8 / mg / PO
-7 / Ondansetron / 8 / mg / PO
Dexamethasone / 12 / mg / PO
Ondansetron / 8 / mg / PO
-6 / Rest day
SCT Conditioning
Fludarabine, cytarabine, Amsacrine, and
IV Busulphan / Height / cm
Weight / kg
BSA / m2
Day / Date / Time / Agent / Dose / Route / Instructions / Doctor / Nurse / Check / Start / Stop
-5 / Aprepitant / 125 / mg / PO
Ondansetron / 8 / mg / PO
Dexamethasone / 12 / mg / PO
Maintain adequate fluid intake (oral or IV fluids) during busulphan aim for 3 litres per 24 hours
-5 / 2000 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
2000 / Busulphan 3.2mg/kg / mg / IV / In 0.545mg/ml 0.9% saline over 2 hours
2200 / Busulphan levels:
5 ml red top tube for each sample, send to toxicology for levels
Ensure ALL levels are taken from separate lumen from busulphan infusion.
Label each sample with time blood taken.
After last sample, fax completed AUC form to: 81162
2230
2400
-4 / 0400
0800 / Aprepitant / 80mg / mg / PO
0800 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
0800 / Dexamethasone / 12 / mg / PO
2000 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
2000 / Busulphan 3.2mg/kg / mg / IV / In 0.545mg/ml 0.9% saline over 2 hours
SCT Conditioning –
Fludarabine, cytarabine, Amsacrine, and
IV Busulphan / Height / cm
Weight / kg
BSA / m2
Day / Date / Time / Agent / Dose / Route / Instructions / Doctor / Nurse / Check / Start / Stop
-3 / 0800 / Aprepitant / 80 / mg / PO
0800 / Ondansetron / 8 / mg / PO / Give IV if not tolerated orally
0800 / Dexamethasone / 12 / mg / PO
Fludarabine 30mg/m2 / mg / IV / In 100mL 0.9% saline over 30 minutes
Hydrocortisone / 100 / mg / IV / Slow bolus one hour prior to ATG
Chlorphenamine / 10 / mg / IV / Slow bolus one hour prior to ATG
Paracetamol / 1000 / mg / PO / One hour prior to ATG
ATG(rabbit) Thymoglobulin 1mg/kg / mg / IV / In 250mL 0.9% saline over 6 hours
2000 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
2000 / Busulphan 3.2mg/kg / mg / IV / In 0.545mg/ml 0.9% saline over 2 hours
-2 / 0800 / Aprepitant / 80 / mg / PO
0800 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
0800 / Dexamethasone / 12 / mg / PO
Fludarabine 30mg/m2 / mg / IV / In 100mL 0.9% saline over 30 minutes
Chlorphenamine / 10 / mg / IV / Slow bolus one hour prior to ATG
Paracetamol / 1000 / mg / PO / One hour prior to ATG
ATG(rabbit) Thymoglobulin 2mg/kg / mg / IV / In 250mL 0.9% saline over 6 hours
2000 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
SCT Conditioning –
Fludarabine, cytarabine, Amsacrine, and
IV Busulphan / Height / cm
Weight / kg
BSA / m2
Day / Date / Time / Agent / Dose / Route / Instructions / Doctor / Nurse / Check / Start / Stop
2000 / Busulphan 1.6mg/kg / mg / IV / In 0.545mg/ml 0.9% saline over 2 hours
-1 / 0800 / Aprepitant / 80 / mg / PO
0800 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
0800 / Dexamethasone / 12 / mg / PO
Hydrocortisone / 100 / mg / IV / Slow bolus one hour prior to ATG
Chlorphenamine / 10 / mg / IV / Slow bolus one hour prior to ATG
Paracetamol / 1000 / mg / PO / One hour prior to ATG
ATG(rabbit) Thymoglobulin 2mg/kg / mg / IV
2000 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
SCT Conditioning –
Fludarabine, cytarabine, Amsacrine, and
IV Busulphan / Height / cm
Weight / kg
BSA / m2
Day / Date / Time / Agent / Dose / Route / Instructions / Doctor / Nurse / Check / Start / Stop
0
0800 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally
0800 / Dexamethasone / 8 / mg / PO
#0.9% saline / For ABO incompatible stem cell products only / 1000 / ml / IV / Prehydration
T = -1hr / #Frusemide / 40 / mg / IV / ABO compatible
Infuse at 300mL/hr for the first 10 mins,
Increase the rate to 600mL/hr for the next 10 mins. Continue to increase the rate to a maximum of 10mL/kg/hr as the patient tolerates. Infuse within 3 hours.
Major ABO incompatibility
Check red cell content and issogutinin titres
1L 0.9% sodium chloride prehydration
Infuse at 20mL/hr for first 30 mins,
Increase to 40mL/hr for next 30 mins,
Increase to 80mL/hr until completion
Minor or mixed ABO incompatibility
As above for “Major incompatibility”
Continue to double the infusion rate every 30 minutes to a maximum of 500mL/hr.
ABO incompatible bone marrow – discuss with transplant consultant.
T = -1hr / #Chlorphenamine / 10 / mg / IV
T = -1hr / #Hydrocortisone / 100 / mg / IV
T = 0 hr / #Haematopoietic stem cells / IV
2000 / Ondansetron / 8 / mg / PO/IV / Give IV if not tolerated orally

# If ABO mismatched: Give premed 1 hour prior to stem cells, graduate the infusion and give prehydration IV fluids.

Authorised by / December 2014
G:\Division\HAE\BMT\Transdocs\BMT Templates\chemotherapy charts\BMT conditioning allo Fludarabine IVBu.docx / Review 2016
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