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9.6
C-VAMP
Version 2008.1
Indication
First line treatment of multiple myeloma patients suitable for
intensive therapy or resistant to alkylator therapy. For more
detail of this regimen and other treatment options in multiple
myeloma, please consult UKMF/BCSH Guidelines on the
diagnosis and management of multiple myeloma
(www.ukmf.org.uk/guidelines). There have been no
randomised trials comparing VAD, VAMP and C-VAMP
Pre-treatment Evaluation
Drug Regimen
Days
1,8 & 15
Drug
Cyclophosphamide
Dose
500mg
Route
IV
1-4
Vincristine
0.4mg/day (ie
total 1.6mg)
IV
1-4
Doxorubicin
IV
1-5
Methyl
Prednisolone
9mg/m/day
(ie total
36mg/m)
1g/m/day
(max
1.5g/day)
Comments
IV infusion in 100mls 0.9%
saline over 15mins
Continuous IV infusion over
4 days in sodium chloride
0.9% (mixed with
Doxorubicin). Minimum
volume 50ml
Continuous IV infusion over
4 days in 0.9% saline (mixed
with Vincristine)
IV/PO
Cycle Frequency
Dose Modifications
Vincristine: If patient complains of significant constipation or
sensory loss in fingers and/or toes, discuss
possible dose reduction with Consultant before
administration.
Doxorubicin: Reduce dose by 50% if Bilirubin is between 2050mol/L.
Discuss if Bilirubin is >50mol/L.
Maximum cumulative dose = 450mg/m
Haematological dose reductions
Concurrent Medication
Anti-emetics
This regimen has moderate emetic potential - refer to local
protocol.
References
Raje N. Powles R. Kulkarni S et al. A comparison of Vincristine
and Doxorubicin infusional chemotherapy with
Methylprednisolone (VAMP) with the addition of weekly
Cyclophosphamide (C-VAMP) as induction treatment followed
by autografting in previously untreated myeloma. Br J
Haematol 1997; 97: 153-60.
Simon
Bolam
Name:
Digitally signed by Simon Bolam
DN: cn=Simon Bolam, o=ASWCS,
ou, email=aswcs@aswcs.nhs.uk,
c=GB
Date: 2009.02.11 14:21:02 Z
Signature:
Date:
Steve Falk