HU-CYT PROTOCOL FOR AML Name:________________________MR:___________

Weight:____ kg, Ht: ____ cm, BSA:_____ m 2

Hydroxyurea (HU): 30 mg/kg/dose PO daily repeated every week. Record actual dose given in milligrams.
Cytarabine (CYT): 300 mg/m2 IV on day 1 repeated every week. Record actual dose given.
Monitor: CBC, Lansky, Toxicity reporting ever week, LFT, weight every other week. Record WBC in
thousands i.e 8,500 as 8.5, Hb in gram/dl, PLT in thousands i.e. 345,000 as 345.
Toxicity: See back, code toxicity i.e. H-1 for grade 1 hematologic toxicity
Lansky performance score: See back.
Wk Date HU CYT WBC Hb PLT ALT DB AST Lansky Tox* Notes
1                        
2                        
3                        
4                        
5                        
6                        
7                        
8                        
9                        
10                        
11                        
12                        
13
14
15

HU-CYT PROTOCOL FOR AML

 (Classification according to NCI Common-Toxicity-Criteria, modified by SIOP)
Grade 0 1 2 3 4
Haematology H-0 H-1 H-2 H-3 H-4
Haemoglobin (g/l) normal for > 100 80 - 100 65 - 79 < 65
age
WBC (x 109/l) > 4.0 3.0 - 3.9 2.0 - 2.9 1.0 - 1.9 < 1.0
Granulocytes (x > 2.0 1.5 - 1.9 1.0 - 1.4 0.5 - 0.9 < 0.5
109/l)
Platelets (x 109/l) > 100 75 - 100 50 - 74.9 25 - 49.9 < 25
Infections I-0 I-1 I-2 I-3 I-4
Infection none mild moderate, pathogen severe, pathogen life threatening,
not identified; identified; with hypotonia
I.V. antibiotics I.V. antibiotics
Fever (°C) none 37.1 - 38 38.1 - 40 > 40 for < 24 h. > 40 for  24 h.
Gut toxicity G-0 G-1 G-2 G-3 G-4
Stomatitis none painless ulcer, erythema painful erythema painful erythema TPN required,
or ulceration, or ulceration, due to stomatitis
can still eat cannot eat
Vomiting 0 1 2-5 6 - 10 > 10 or TPN
(number of episodes necessary
in 24h)
Diarrhoea none 2-3 4 - 6 or nightly stool 7 - 9 or incontinence  10 or bloody
(stool/day) or light cramps or severe cramps diarrhoea or
TPN required
Skin toxicity S-0 S-1 S-2 S-3 S-4
changes in the skin none erythema dry desquamation, moist desquamation, exfoliative dermatitis,
vasculitis, pruritus ulceration necrosis
Renal toxicity R-0 R-1 R-2 R-3 R-4
Creatinine normal for < 1.5 x N 1.5 - 3.0 x N 3.1 - 6.0 x N >6xN
age
Proteinuria (g/l) none <3 3 - 10 > 10 nephrot. Syndrome
Haematuria none microscopic macroscopic, macroscopic, clots transfusion required
no clots
Glomerular  90 60 - 89 40 - 59 20 - 39  19
Filtration Rate (GFR)
ml/mn/1.73m²
Liver toxicity L-0 L-1 L-2 L-3 L-4
Bilirubin normal for - < 1.5 x N. 1.5. - 3 x N. > 3 x N.
age
SGOT / SGPT normal for  2.5 x N 2.6 - 5.0 x N. 5.1 - 20.0 x N. > 20 x N.
age
Cardiac toxicity C-0 C-1 C-2 C-3 C-4
Cardiac function normal asymptomat., asymptomat., mild CHF, severe / refractory
EF  of <20% of EF  of >20% of therapeutically Congestive Heart
baseline baseline compensated Failure
Echocardiogram: > 30 % 28-30% transient 28-30 % transient < 28 %, transient < 28 % permanent or
LV-SF ¯? <10% from baseline ¯? >10% from treatment required
baseline
Neurological toxicity N-0 N-1 N-2 N-3 N-4
Central none mild somnolence, somnolence somnolence coma, seizures
neurotoxicity or agitation, drowsiness < 50% of the time, > 50% of the time,
moderate severe disorientation,
disorientation hallucinations
Peripheral none paresthesia, mild severe paresthesia unbearable Paralysis
neurotoxicity subjective weakness and/or mild weakness paresthesia, deficits in
motor funct.
Anaphylaxis

LANSKY SCORE
Fully Active, normal 100
Minor restrictions in strenuous physical activity 90
Active, but tired more quickly 80
Greater restriction of play and less time spent in play activity 70
Up and around, but active play minimal; keeps busy by being 60
involved in quieter activities
Lying around much of the day, but gets dresses; no active playing, 50
participates in all quiet play and activities
Mainly in bed; participates in quiet activities 40
Bed-bound; needing assistance even for quiet activities 30
Sleeping often; play entirely limited to very passive activities 20
Doesn’t play; does not get out of bed 10
Unresponsive 0

HU-CYT PROTOCOL FOR AML

HU-CYT PROTOCOL FOR AML