Protocol Index	

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OP APML4 MAINTENANCE	

Types:      ONCOLOGY TREATMENT
Synonyms:  ACUTE, PROMYEL, APL, ATRA, IDAR, ATO, ARSE, TRIO, ALL, TRANS, RETINO, MAIN

Take-Home Medications	Repeat 1 time	Cycle length: 1 day	Labs and Take-Home Medications	Perform every 1 day x1		Take-Home Medications Prior to Treatment
  	tretinoin (VESANOID) 10 mg chemo capsule	Dose: 22.5 mg/m2	Route: oral	2 times daily	Dispense: --	Refills: --	Start: S			Instructions:	DO NOT CRUSH, CHEW, OR DISSOLVE CAPSULE.  Administer with meals.			Take-Home Medications Prior to Treatment
  	methotrexate 2.5 MG tablet	Dose: 5 mg/m2	Route: oral	weekly	Dispense: --	Refills: --	Start: S+14	End: S+85		Instructions:	CYTOTOXIC AGENT  DO NOT OPEN OR CRUSH. Swallow whole.			Take-Home Medications Prior to Treatment
  	mercaptopurine (PURINETHOL) 50 mg chemo tablet	Dose: 50 mg/m2	Route: oral	daily	Dispense: --	Refills: --	Start: S+14	End: S+90		Comments:	On days 1 through 14 of treatment in all cycles.  Take a least 1 hour after evening meal without milk or citrus products.	Instructions:	Take a least 1 hour after evening meal without milk or citrus products.			Provider Communication
  	ONC PROVIDER COMMUNICATION 64	Interval: --	Occurrences: --	Comments:	Verify Hep B panel status prior to cycle. Date *** of panel. Result positive/negative/pending/unknown:22867

The required components for the hepatitis B panel includes: Hepatitis B surface antigen (HBsAg), total hepatitis B core antibody (anti-HBc), and hepatitis B antibody (anti-HBs).
			Provider Communication
  	ONC PROVIDER COMMUNICATION 26	Interval: --	Occurrences: --	Comments:	Adjust oral methotrexate and mercaptopurine to target a neutrophil count of 1000 -2000.