Madison Wisconsin lymphoma protocol

The Madison Winsconsin lymphoma protocol is a chemotherapy regimen.

Week 1:

• Vincristine 0.7 mg/m2 IV
• Asparaginase 400 IU/kg IM
• Pre-med with chlorphenamine: small-medium 2.5 - 5 mg IM; medium-large 5 - 10 mg IM
• Prednisolone 2 mg/kg PO SID
• Cimetidine 2 mg/kg PO BID

Week 2:

• Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)
• Prednisolone 1.5 mg/kg PO SID
• Stop antacids: after week 2

Week 3:

• Vincristine 0.7 mg/m2 IV
• Prednisolone 1 mg/kg PO SID

Week 4:

• Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl) - for dogs < 10 Kg, use 1 mg/Kg dose of doxorubicin
• Pre-med with chlorphenamine and
• Metoclopramide 0.5-1 mg/kg IM/SC
• Prednisolone 0.5 mg/kg PO SID

Week 6:

• Vincristine 0.7 mg/m2 IV

Week 7:

• Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)

Week 8:

• Vincristine 0.7 mg/m2 IV

Week 9:

• Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
• Pre-med with chlorphenamine + metoclopramide

Week 11:

• Vincristine 0.7 mg/m2 IV

Week 13:

• Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)

Week 15:

• Vincristine 0.7 mg/m2 IV

Week 17:

• Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
• Pre-med with chlorphenamine + metoclopramide

Week 19:

• Vincristine 0.7 mg/m2 IV

Week 21:

• Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)

Week 23:

• Vincristine 0.7 mg/m2 IV

Week 25:

• Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
• Pre-med with chlorphenamine + metoclopramide

Haematology should be performed prior to each dose and urinalysis after every cyclophosphamide dose. A full urinalysis should be performed after week 7.

A cardiac echocardiogram should be performed at the time of first and last doxorubicin dose.

All treatment is discontinued after week 25 if in complete remission.

If neutrophil count is < 3 × 109/L wait 5-7 days and repeat haematology before giving chemo.

If sterile haemorrhagic cystitis occurs on cyclophosphamide, discontinue and substitute Chlorambucil (1.4 mg/kg PO) for subsequently scheduled cyclophosphamide injections.

Administer L-asparaginase (400 IU/kg IM) with each vincristine injection until clinical remission is achieved.