Protocols - Hemorio

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Acute Promyelocytic Leukemia Transfusion-related support for coagulopathy • TX Platelets to keep count > 50000 • TX Plasma to keep INR and PTT < 1.5 • TX Cryoprecipitated to keep Fibrinogen > 100 Induction - AIDA • ATRA 45mg/m 2 VO /day until RC (hematological remission) • Idarubicin 12mg/m 2 /day EV, alternate days, (D2, D4, D6, D8) Consolidation - 3 cycles of QT (outpatient treatment) • 1 st Cycle – Idarubicin 7mg/m 2 EV D1 – D4 + ATRA • 2 nd Cycle – Mitoxantrone 10mg/m 2 EV D1 – D5 + ATRA • 3 rd Cycle – Idarubicin 12mg/m 2 EV D1 and D2 + ATRA • ATRA 45mg/m 2 D1-D15 in 3 cycles Consider a cycle of HDAC in case PCR+ after 3 cycles of consolidation Maintenance (in a way the total duration of the treatment is of 2 years) • ATRA 45 mg/m 2 /days 15 days VO every 3 months • 6-MP 50mg/m 2 VO/day • MTX 20mg/m 2 VO/week Monitoring • PCR at the end of MO consolidation • PCR every 6 months for 4 years in MO • In case of PCR+, without hematological manifestation, repeat the test in 1 month and in case it persists +, start treatment according RELAPSE protocol Relapse IDEALLY: Re-induction with Arsenic Trioxide • As2O3 0.15mg/kg/day EV from Monday to Thursday until 2 nd Complete Remission. Do not exceed 60 doses. If arsenic is not available yet • RC > 1 year – Treatment according to original protocol • RC < 1 year - Treatment according to protocol LMA Low Risk + ATRA on Induction At the end of treatment, evaluate: If PCR - - Auto TMO If there is relapse after Auto TMO Alo TMO If PCR + - If there is a donor Alo TMO If there is no donor Maintenance or palliative treatment ATRA Syndrome Diagnosis (without other causes that justify) • Fever • Weight increased • Respiratory discomfort • Pulmonary infiltrate • Pleural-pericardic effusion • Hypotension • Renal failure 96
Treatment • Dexametasone 10mg EV 12/12h for at least 3 days • Consider ATRA suspension according to symptoms severity • Diuretic, if there are stable hemodynamic conditions • Always try and re-introduce ATRA in case it has already been suspended. Prophylaxis - PDN 0.5 mg/kg/day 97
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PROTOCOLS INSTITUTE OF HAEMATOLOGY
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COORDINATION AND REVISION Clarisse
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SUMMARY: PART I - CLINICAL PROTOCOL
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1.INICIAL CLINICAL EVALUATION SICKL
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TREATMENTO AND IN ADULTS AT ANY AGE
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SPLENECTOMY - INDICATIONS: (1) CHIL
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OUTPATIENT TREATMENT: It is based o
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ASPIRIN AND NSAID PARACETAMOL OPIOI
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CONDUCTION: - Hospitalization - Com
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ONE, TWO-DIMENSIONAL DOPPLER ECHOCA
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Hemianopsia Homonymous deficit of v
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TREATMENT OF CONVULSIVE EPISODES -
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INITIAL ATTENDANCE TO PREGNANT WOME
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- It may occurs acute thoracic synd
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3 Diet with potassium restriction 4
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MICROALBUMINURIA Screening Patients
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RECURRENCE OF PRIAPISM: - Pain Trea
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SPECIAL CARES DEFERASIROX - The use
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TREATAMENT: DRUG Hydroxiurea (hard
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MAJOR AND INTERMIDIATE THALASSEMIA
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HEREDIRATY SPHEROCYTOSIS CLINICAL E
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G6PD DEFICIENCY INITIAL EVALUATION
Page 46 and 47: LABS EXAMS TO DIAGNOSE APLASTIC ANE
Page 48 and 49: SELFIMMUNE HEMOLYTIC ANEMIA CONCEPT
Page 50 and 51: 2. Splenectomy: Vaccinate 14 days b
Page 52 and 53: IMMUNE THROMBOCYTOPENIC PURPURA LAB
Page 54 and 55: THROMBOTIC THROMBOCYTOPENIC PURPURA
Page 56 and 57: HEMORRHAGIC SYNDROME INTRODUCTION H
Page 58 and 59: MULTIDISCIPLINARY FOLLOW-UP OF HEMO
Page 60 and 61: LYOPHILIZED CONCENTRATES: They are
Page 62 and 63: TABLE 2: REPLACEMENT THERAPY TO PER
Page 64 and 65: CONDUCTION IN CONFIRMED INTRACRANIA
Page 66 and 67: Severe CET with neurological change
Page 68 and 69: PHARMACOKINETICS OF CLOTTING FACTOR
Page 70 and 71: INHIBITORS CLASSIFICATION The inhib
Page 72 and 73: - Extended surgeries require increa
Page 74 and 75: CLINICAL DIAGNOSIS: According to In
Page 76 and 77: DDAVP TEST The “test dose” must
Page 78 and 79: TREATMENT OF BLEEDING SITUATIONS SI
Page 80 and 81: TABLE 6 - REPLACEMENT THERAPY IN LE
Page 82 and 83: • Primary prophylaxis: controvers
Page 84 and 85: CLINICAL AND LABORATORIAL FOLLOW-UP
Page 86 and 87: MYELODISPLASIC SYNDROME LABORATORIA
Page 88 and 89: If EPO < 500 mU/ml : EPO (8000U 3x/
Page 90 and 91: ACUTE MYELOID LEUKEMIA LABORATORIAL
Page 92 and 93: LMA LMA M3 - non-M3 LMA Protocol LM
Page 94 and 95: Key: Volunteer to aggressive treatm
Page 98 and 99: BMP LMA IN CHILDREN AND TEENAGERS
Page 100 and 101: Ara-c dose reduction by age: Age in
Page 102 and 103: ATRA RECOMMENDATION: ATRA is starte
Page 104 and 105: - venous hydration - leukapheresis
Page 106 and 107: POLYCYTHEMIA VERA LABORATORIAL TEST
Page 108 and 109: TREATMENT - 2nd LINE - Indicated fo
Page 110 and 111: ACUTE LYMPHOID LEUKEMIA LABORATORIA
Page 112 and 113: RE-INDUCTION Phase I (weeks 1-4) -
Page 114 and 115: Cycles 2, 4, 6, 8 - Methotrexate 20
Page 116 and 117: PHASE 2 Infusion CPM in 1 hour 1000
Page 118 and 119: CURATIVE RADIOTHERAPY of CNS < 1 ye
Page 120 and 121: CHRONIC LYMPHOCYTIC LEUKEMIA LABORA
Page 122 and 123: fludarabine 25 mg/m VENOUS 2 D1-D3
Page 124 and 125: TRICHOLEUKEMIA LABORATORIAL TESTS -
Page 126 and 127: - age >45 years old - leukocytosis
Page 128 and 129: - Leukemia / T-Cell Lymphoma in Adu
Page 130 and 131: INDICATIONS FOR THE TREATMENT: Symp
Page 132 and 133: 1 st line Chemotherapy R- CHOP (21
Page 134 and 135: CODOX- M/IVAC Cycles 1 and 3 Cyclop
Page 136 and 137: BLOCK A DEXA VO/IV 10 mg /m2 in 3 d
Page 138 and 139: - Surgical treatment is only indica
Page 140 and 141: LEUKEMIA / T-CELLS LYMPHOMA OF THE
Page 142 and 143: HN2 or PUVA (similar to the located
Page 144 and 145: MULTIPLE MYELOMA LABORATORIAL TESTS
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RESPONSE CRITERIA Full Response Abs
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WALDENSTRON MACROGLOBULINEMIA LABOR
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− If HLA-identical related donor
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TREATMENT PROTOCOL - ACUTE MYELOID
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TREATMENT PROTOCOL - MULTIPLE MYELO
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Post-autologous transplantation pro
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PART II - TRANSFUSIONAL PROTOCOLS A
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PRESERVATION AND CONSERVATION: The
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TRANSFUSION OF RED BLOOD CELLS, PLA
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FORMAL CONTRAINDICATIONS TO THE PLA
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1 - TRANSFUSION OF FROZEN FRESH PLA
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COMMUNICATION FORM OF CRYOPRECIPITA
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Volume to be = changed (*) VOLEMIA
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HEMOTHERAPIC PROTOCOL TO FALCIFORM
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5 - TRANSFUSIONAL CONDUCT AT THE SE
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CML - Subjects with symptoms relate
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- Aplastic anemia bearers - HIV pos
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Severe reaction: anaphylactic shock
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- Heart monitoring - Prescribe Furo
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CARES AT THE PLATELETS CONCENTRATE
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ATTACHMENT I - HEMATOLOGICAL CLINIC
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INFECTIOUS SPLENO MEGALIES IMMUNO L
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INVESTIGATION OF HEMORRHAGIC SYNDRO
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INVESTIGATION OF POLYGLOBULIAS: POL
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ATTACHMENT III - HEMATOLOGY SPECIAL
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IMMUNOPHENOTYPE PROFILE OF THE ACUT
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ATTACHMENT IV - PAIN APPROACH ROUTI
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If it is prescribed for more than 1
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HOW TO PRESCRIBE OPIOID: SPECIAL CA
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SPECIFICITIES OF EACH OPIATE (cont
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METHADONE Intravenous (*) Oral path
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Psychic Dependence or “addiction
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CROSS TOLERANCE - The subject must
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ATTACHMENT V - CHEMOTHERAPY SUBJECT
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ATTACHMENT VII - IRON CHELATION GEN
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10. G N N - DFP DFP-100 mg/kg/day d
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ATTACHMENT VIII - SEDATION IN CHILD
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224 NOTES _________________________
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224 NOTES _________________________
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Expresso Gráfica e Editora Ltda-me
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