fludarabine

Adult Dosing .

Dosage forms:  INJ

Special Note

[uses, dosing may vary]

Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments

CLL

[first-line tx, combo tx]

Dose: 25 mg/m^2/dose IV x1 on days 1-3 of 28-day cycle x6 cycles

[progressive dz, monotherapy]

Dose: 25 mg/m^2/dose IV x1 on days 1-5 of 28-day cycle

allogeneic HSCT conditioning tx (off-label)

[AML]

Dose: 30 mg/m^2/dose IV q24h on days -6, -5, -4, -3, -2 prior to transplantation; Info: use w/ treosulfan

[MDS]

Dose: 30 mg/m^2/dose IV q24h on days -6, -5, -4, -3, -2 prior to transplantation; Info: use w/ treosulfan

lymphodepleting tx, pre-afamitresgene autoleucel (off-label)

[melanoma-associated antigen A4 (MAGE-A4)-positive synovial sarcoma, unresectable or metastatic]

Dose: 30 mg/m^2/dose IV q24h x4 doses; Start: 7 days prior to afamitresgene autoleucel tx; Info: use w/ cyclophosphamide

lymphodepleting tx, pre-axicabtagene ciloleucel (off-label)

[follicular lymphoma, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to axicabtagene ciloleucel tx; Info: use w/ cyclophosphamide

[large B-cell lymphoma, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to axicabtagene ciloleucel tx; Info: use w/ cyclophosphamide

lymphodepleting tx, pre-brexucabtagene autoleucel (off-label)

[mantle cell lymphoma, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to brexucabtagene autoleucel tx; Info: use w/ cyclophosphamide

[B-cell precursor ALL, relapsed or refractory]

Dose: 25 mg/m^2/dose IV q24h x3 doses; Start: 4 days prior to brexucabtagene autoleucel tx; Info: use w/ cyclophosphamide

lymphodepleting tx, pre-ciltacabtagene autoleucel (off-label)

[multiple myeloma, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to ciltacabtagene autoleucel tx; Info: use w/ cyclophosphamide

lymphodepleting tx, pre-idecabtagene vicleucel (off-label)

[multiple myeloma, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to idecabtagene vicleucel; Info: use w/ cyclophosphamide

lymphodepleting tx, pre-lifileucel (off-label)

[melanoma, unresectable or metastatic]

Dose: 25 mg/m^2/dose IV q24h x5 doses; Start: 6 days prior to lifileucel tx; Info: use w/ cyclophosphamide

lymphodepleting tx, pre-lisocabtagene maraleucel (off-label)

[large B-cell lymphoma, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to lisocabtagene maraleucel tx; Info: use w/ cyclophosphamide

[CLL/SLL, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to lisocabtagene maraleucel tx; Info: use w/ cyclophosphamide

[follicular lymphoma, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to lisocabtagene maraleucel tx; Info: use w/ cyclophosphamide

[mantle cell lymphoma, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to lisocabtagene maraleucel tx; Info: use w/ cyclophosphamide

lymphodepleting tx, pre-obecabtagene autoleucel (off-label)

[B-cell precursor ALL, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x4 doses; Start: 6 days prior to obecabtagene autoleucel tx; Info: use w/ cyclophosphamide

lymphodepleting tx, pre-tisagenlecleucel (off-label)

[B-cell precursor ALL, relapsed or refractory]

Dose: 30 mg/m^2/dose IV q24h x4 doses; Start: 6 days prior to tisagenlecleucel tx; Info: for pts 25 yo and younger; use w/ cyclophosphamide

[large B-cell lymphoma, relapsed or refractory]

Dose: 25 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to tisagenlecleucel tx; Info: use w/ cyclophosphamide

[follicular lymphoma, relapsed or refractory]

Dose: 25 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to tisagenlecleucel tx; Info: use w/ cyclophosphamide

renal dosing

[see below]

CrCl 50-79: decr. usual dose by 20%; CrCl 30-49: decr. usual dose by 40%; CrCl <30: not defined

HD: decr. usual dose by 50-75%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by 50%; supplement not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  INJ

Special Note

[uses, dosing may vary]

Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments

ALL (off-label)

[1 yo and older]

Dose: 10.5 mg/m^2/dose IV x1 on day 1, then 30.5 mg/m^2/24h IV infusion x5 days

solid tumor (off-label)

[1 yo and older]

Dose: 7 mg/m^2/dose IV x1 on day 1, then 20 mg/m^2/24h IV infusion x5 days

allogeneic HSCT conditioning tx (off-label)

[AML, 1 yo and older]

Dose: 30 mg/m^2/dose IV q24h on days -6, -5, -4, -3, -2 prior to transplantation; Info: use w/ treosulfan

[MDS, 1 yo and older]

Dose: 30 mg/m^2/dose IV q24h on days -6, -5, -4, -3, -2 prior to transplantation; Info: use w/ treosulfan

lymphodepleting tx, pre-tisagenlecleucel (off-label)

[3 yo and older]

Dose: 30 mg/m^2/dose IV q24h x4 doses; Start: 6 days prior to tisagenlecleucel tx; Info: for pts w/ relapsed or refractory B-cell precursor ALL; use w/ cyclophosphamide

renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: consider adult renal dosing for guidance

hepatic dosing

[not defined]