This is the Plan for the next 63 days.

CONSOLIDATION OF REMISSION: (This is the worst phase of therapy.) Considation means that Lue is gone but the world of M-E's Body is going to make sure it never comes back!!!!

DAY 35/0
September 20
IT-Methotrexate
Start cranial radiation (9 days cranial; 3 days include spinal plus three or four more of the bump)
Overnight in the hospital for cytoxan ( This is so nasty they only give in the hospital.) This will not be a pleasant night. & Ara-C Mercaptopurine ( Oral)
9-21 Ara-C IV Children's Hospital Mercaptopurine
9-22 Ara-C IV Children's Hospital
Begin Spinal/Cranial Radiation U of W Hospital Mercapurine

9-23 Ara-C IV Children's Hospital
Day 2 Spinal/Cranial Radiation U of W Hospital Mercapurine
9-24 Day 3 Spinal Cranial Radiaion U of W Hospital Mercapurine
9-25 Mercaptopurine
9-26 Mercaptopurine Hold Lovanox after A.M. injection

Day 7:
9-27 Mercaptopurine

IT Methotrexate Arc-C Children's Hospital Bactrim

Day 4 Spinal Cranial Radiation U of W Hospital

9-28 Mercaptopurine Bactrim Arc-C @ Children's Hospital
Day 5 Spinal Cranial Radiation U of W Hospital
9-29 Mercaptopurine Arc-C Children's Hospital
Day 6 Spinal Cranial Radiation U of W Hosptial
9-30 Mercaptopurine Arc-C Children's Hospital
Day 7 Spinal Cranial Radiation U of W Hospital
10-1 Mercaptopurine
Day 8 Spinal Cranial Radiation U of W housefly
10-2 Mercaptopurine
10-3 Mercaptopurin
Check counts frequently - may need transfusions
DAY 14
10-4 Bactrim
Day9 Spinal Cranial Radiation U of W Hospital BCR/PEG Asperigus Shot Children's Hospital
10-5- Day 10 Cranial Radiation Bactrim
10-6 Day 11 Cranial Radiation
10-7 Day 12 Cranial Radiation
10-8
10-9 Check counts frequently may need to be tranfused.
10-10

Day 21

10-11 Vincristin IV at Children's Hospital, Bactrim
10-1 2 Bactrim
10-13
10-14
10-15
10-16
10-17

DAY 28

10-18 Bactrim Cytoxan overnight in at Childrens Ara-C **
10-19 Mercaptopurine, Ara-C IV Children's Hospital Bactrim
10-20 Mercaptopurine Ara-C @ Children's Hospital
10-21 Mercaptopurine Ara-C@ Children's hospital
10-22 Mercaptopurine
10-23 Mercaptopurine
10-24 Mercaptopurine

DAY 35

10-25 Mercaptopurine Bactrim & Ara-C @ Children's Hospital
10-26 Bactrim Mercaptopurine & Ara-C@ Children's Hospital
10-27 Mercaptopurine & Ara-C@ Children's Hospital
10-28 Mercaptopurine & Ara-C@ Children's Hospital
10-29 Mercaptopurine
10-30 Mercaptopurine
10-31 Mercaptopurine
Check counts frequently - may need transfusions


DAY 42

Check counts frequently - may need transfusions
Nov 1 Mercaptopurine VCR/PEG ASP shot Bactrim @/Children's Hospital
Nov 2 Bactrim
Nov3
Nov 4
Nov 5
Nov 6
Nov 7

DAY 49

Nov 8 Vincristine Bactrim @Children's Hospital
Nov 9 Bactrim
Nov 10
Nov 11
Nov 12
Nov13
Nov 14

DAY 56
Nov 15 Labs and evaluation Bactrim
Nov 16 Bactrim
Nov17
Nov 18
Nov 19
Nov 20
Nov 21 Hold PM Lovinox

DAY 63

Nov 22 Bactrim Hold Lovinox AM IT Methotrexate Bactrim
Nov 23 Bactrim

Move to Interim Maintenance if Possible

____________________________________________________________________
Medications given in clinic or hospital:
Cyclophosphamide (Cytoxan) - IV in hospital with fluids; side effects: nausea (given with Zofran), low counts
Cytarabine (Ara-C) - IVP with zofran; side effects: fever, rash, dropping counts, mouth sores, poor appetite
Vincristine (VCR) - IV push; side effects: constipation, jaw/leg pain
PEG Asparaginase (PEG ASP) - IM shot into muscle; need to stay in clinic for 1 hour after receiving
Side effects: allergic (hives, wheezing, swollen lips); can also become red, swollen and slightly sore right around site
Ice helps the best for IM injections - the EMLA only numbs the top of the skin so is not very helpful for the shots
Medications at home:
Mercaptopurine (Purinethol) - oral chemotherapy given in the evening
Bactrim (sulfamethoxazole-trimethoprim) - oral antibiotic to prevent PCP pneumonia; twice a day on Mon & Tues only
Ondansetron (Zofran) - every 8 hours as needed for nausea; will receive dose in clinic with Ara-C if >6 hours since last dose