Protocol Index	

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RSH PRO00037811 NCT05578976 / ARM A	

Types:      Research Oncology Treatment
Synonyms:  ARM1

Cycle 1	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Randomization.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Eligibility criteria
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Medical/surgical history.

he subject's medical history will be updated predose at C1D1 visit.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Disease status and subtype
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Mandatory physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dispense Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pharmacokinetic samples
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	ADA/nAb
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	T-cell receptor clonality
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood PG DNA Sample
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood NGS
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood ctDNA (MRD)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood for exploratory biomarkers
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Take-Home Medications Prior to Treatment
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	The prednisone will be taken from the patient's supply that was dispensed through IDS pharmacy at HMH with PO 100 mg daily for 5 days.
			Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-VinCRIStine (M20-621/PRO00037811/PINGALI) 1.4 mg/m2 in sodium chloride 0.9% 50 mL	Dose: 1.4 mg/m2	Route: intravenous	once over 15 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Infuse IV over 15 minutes starting 30 minutes after treatment start time.  

Protect from light, VESICANT. 
Max dose = 2mg.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (M20-621/PRO00037811/PINGALI)	Medications	1.4 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	50 mL	Yes	Yes			  	INV-DOXOrubicin (M20-621/PRO00037811/PINGALI) 50 mg/m2 in sodium chloride 0.9% 100 mL	Dose: 50 mg/m2	Route: intravenous	once over 10 Minutes for 1 dose			Offset: 60 Minutes	Instructions:	Infuse IV over 10 minutes once, starting 60 minutes after treatment start time.  

Protect from light; VESICANT.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-DOXORUBICIN 50 MG INTRAVENOUS SOLN (M20-621/PRO00037811/PINGALI)	Medications	50 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			  	INV-cycloPHOSphamide (M20-621/PRO00037811/PINGALI) 750 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 750 mg/m2	Route: intravenous	once over 60 Minutes for 1 dose			Offset: 1.5 Hours	Instructions:	Infuse IV over 60 minutes starting 1.5 hours after treatment start time.  Stable for 24 hours at room temperature (36 hours refrigerated).  

HAZARDOUS - Handle with care	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-CYCLOPHOSPHAMIDE 500 MG IV POWDER FOR SOLN (M20-621/PRO00037811/PINGALI)	Medications	750 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes			  	INV-RiTUXimab (M20-621/Pro00037811/Pingali) 375 mg/m2 in sodium chloride 0.9% INFUSION	Dose: 375 mg/m2	Route: intravenous	once for 1 dose			Offset: 2 Hours	Instructions:	Initiate infusion at rate of 50 mg/hour.  In the absence of infusion toxicity (SBP within 20 mmHG of baseline, PULSE between 60 and 120 and TEMP less than 38 degrees C, and no symptoms), then increase infusion rate by 50 mg/hour every 30 minutes, to a maximum rate of 400 mg/hour.  
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS  (M20-621/PRO00037811/PINGALI)	Medications	375 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	 	Yes	Yes				Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) 0.16 mg in sodium chloride 0.9% 1 mL subcutaneous injection	Dose: 0.16 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-EPCORITAMAB 4 MG/0.8 ML SUBCUTANEOUS SOLUTION (MUST DILUTE) (M20-621/PRO00037811/PINGALI)	Medications	0.16 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	0.97 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 2	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Supportive Care
  	pegfilgrastim-jmdb (FULPHILA) injection (RESTRICTED)	Dose: 6 mg	Route: subcutaneous	once for 1 dose	Start: S						Day 8	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pharmacokinetic samples
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) 0.8 mg in sodium chloride 0.9% 1 mL subcutaneous injection	Dose: 0.8 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-EPCORITAMAB 4 MG/0.8 ML SUBCUTANEOUS SOLUTION (MUST DILUTE) (M20-621/PRO00037811/PINGALI)	Medications	0.8 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	0.84 mL	Yes	Yes				Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 15	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pharmacokinetic samples
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 16	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pharmacokinetic samples
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 2	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	PGIC

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dispense Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Collect and review Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pharmacokinetic samples
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood NGS
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood ctDNA (MRD)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood for exploratory biomarkers
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	ADA/nAb
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Take-Home Medications Prior to Treatment
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	The prednisone will be taken from the patient's supply that was dispensed through IDS pharmacy at HMH with PO 100 mg daily for 5 days.
			Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-VinCRIStine (M20-621/PRO00037811/PINGALI) 1.4 mg/m2 in sodium chloride 0.9% 50 mL	Dose: 1.4 mg/m2	Route: intravenous	once over 15 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Infuse IV over 15 minutes starting 30 minutes after treatment start time.  

Protect from light, VESICANT. 
Max dose = 2mg.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (M20-621/PRO00037811/PINGALI)	Medications	1.4 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	50 mL	Yes	Yes			  	INV-DOXOrubicin (M20-621/PRO00037811/PINGALI) 50 mg/m2 in sodium chloride 0.9% 100 mL	Dose: 50 mg/m2	Route: intravenous	once over 10 Minutes for 1 dose			Offset: 60 Minutes	Instructions:	Infuse IV over 10 minutes once, starting 60 minutes after treatment start time.  

Protect from light; VESICANT.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-DOXORUBICIN 50 MG INTRAVENOUS SOLN (M20-621/PRO00037811/PINGALI)	Medications	50 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			  	INV-cycloPHOSphamide (M20-621/PRO00037811/PINGALI) 750 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 750 mg/m2	Route: intravenous	once over 60 Minutes for 1 dose			Offset: 1.5 Hours	Instructions:	Infuse IV over 60 minutes starting 1.5 hours after treatment start time.  Stable for 24 hours at room temperature (36 hours refrigerated).  

HAZARDOUS - Handle with care	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-CYCLOPHOSPHAMIDE 500 MG IV POWDER FOR SOLN (M20-621/PRO00037811/PINGALI)	Medications	750 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes			  	INV-RiTUXimab (M20-621/Pro00037811/Pingali) 375 mg/m2 in sodium chloride 0.9% INFUSION	Dose: 375 mg/m2	Route: intravenous	once for 1 dose			Offset: 2 Hours	Instructions:	Initiate infusion at rate of 50 mg/hour.  In the absence of infusion toxicity (SBP within 20 mmHG of baseline, PULSE between 60 and 120 and TEMP less than 38 degrees C, and no symptoms), then increase infusion rate by 50 mg/hour every 30 minutes, to a maximum rate of 400 mg/hour.  
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS  (M20-621/PRO00037811/PINGALI)	Medications	375 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	 	Yes	Yes				Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 2	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Supportive Care
  	pegfilgrastim-jmdb (FULPHILA) injection (RESTRICTED)	Dose: 6 mg	Route: subcutaneous	once for 1 dose	Start: S						Day 8	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pharmacokinetic samples
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 15	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Imaging
  	PET CT LIMITED	Interval: --	Occurrences: --	Comments:	PET scan with low-dose CT .

For study exploratory biomarkers
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Pharmacokinetic samples
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 3	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	PGIC

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dispense Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Collect and review Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	CYTOMEGALOVIRUS (CMV), QUANTITATIVE, PLASMA, PCR	Interval: --	Occurrences: --	Comments:	For subjects with a positive screening CMV PCR test that has not demonstrated viral clearance prior to C1D1, or for all subjects whose PCR test becomes positive at any time, then the CMV DNA PCR test should be repeated more frequently and CMV treatment initiated or continued as appropriate, per investigator's discretion and institutional SOC.
			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood NGS
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood ctDNA (MRD)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood for exploratory biomarkers
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	ADA/nAb
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Take-Home Medications Prior to Treatment
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	The prednisone will be taken from the patient's supply that was dispensed through IDS pharmacy at HMH with PO 100 mg daily for 5 days.
			Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-VinCRIStine (M20-621/PRO00037811/PINGALI) 1.4 mg/m2 in sodium chloride 0.9% 50 mL	Dose: 1.4 mg/m2	Route: intravenous	once over 15 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Infuse IV over 15 minutes starting 30 minutes after treatment start time.  

Protect from light, VESICANT. 
Max dose = 2mg.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (M20-621/PRO00037811/PINGALI)	Medications	1.4 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	50 mL	Yes	Yes			  	INV-DOXOrubicin (M20-621/PRO00037811/PINGALI) 50 mg/m2 in sodium chloride 0.9% 100 mL	Dose: 50 mg/m2	Route: intravenous	once over 10 Minutes for 1 dose			Offset: 60 Minutes	Instructions:	Infuse IV over 10 minutes once, starting 60 minutes after treatment start time.  

Protect from light; VESICANT.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-DOXORUBICIN 50 MG INTRAVENOUS SOLN (M20-621/PRO00037811/PINGALI)	Medications	50 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			  	INV-cycloPHOSphamide (M20-621/PRO00037811/PINGALI) 750 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 750 mg/m2	Route: intravenous	once over 60 Minutes for 1 dose			Offset: 1.5 Hours	Instructions:	Infuse IV over 60 minutes starting 1.5 hours after treatment start time.  Stable for 24 hours at room temperature (36 hours refrigerated).  

HAZARDOUS - Handle with care	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-CYCLOPHOSPHAMIDE 500 MG IV POWDER FOR SOLN (M20-621/PRO00037811/PINGALI)	Medications	750 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes			  	INV-RiTUXimab (M20-621/Pro00037811/Pingali) 375 mg/m2 in sodium chloride 0.9% INFUSION	Dose: 375 mg/m2	Route: intravenous	once for 1 dose			Offset: 2 Hours	Instructions:	Initiate infusion at rate of 50 mg/hour.  In the absence of infusion toxicity (SBP within 20 mmHG of baseline, PULSE between 60 and 120 and TEMP less than 38 degrees C, and no symptoms), then increase infusion rate by 50 mg/hour every 30 minutes, to a maximum rate of 400 mg/hour.  
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS  (M20-621/PRO00037811/PINGALI)	Medications	375 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	 	Yes	Yes				Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 2	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Supportive Care
  	pegfilgrastim-jmdb (FULPHILA) injection (RESTRICTED)	Dose: 6 mg	Route: subcutaneous	once for 1 dose	Start: S						Day 8	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 15	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 4	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	PGIC

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dispense Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Collect and review Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	ADA/nAb
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Take-Home Medications Prior to Treatment
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	The prednisone will be taken from the patient's supply that was dispensed through IDS pharmacy at HMH with PO 100 mg daily for 5 days.
			Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-VinCRIStine (M20-621/PRO00037811/PINGALI) 1.4 mg/m2 in sodium chloride 0.9% 50 mL	Dose: 1.4 mg/m2	Route: intravenous	once over 15 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Infuse IV over 15 minutes starting 30 minutes after treatment start time.  

Protect from light, VESICANT. 
Max dose = 2mg.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (M20-621/PRO00037811/PINGALI)	Medications	1.4 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	50 mL	Yes	Yes			  	INV-DOXOrubicin (M20-621/PRO00037811/PINGALI) 50 mg/m2 in sodium chloride 0.9% 100 mL	Dose: 50 mg/m2	Route: intravenous	once over 10 Minutes for 1 dose			Offset: 60 Minutes	Instructions:	Infuse IV over 10 minutes once, starting 60 minutes after treatment start time.  

Protect from light; VESICANT.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-DOXORUBICIN 50 MG INTRAVENOUS SOLN (M20-621/PRO00037811/PINGALI)	Medications	50 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			  	INV-cycloPHOSphamide (M20-621/PRO00037811/PINGALI) 750 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 750 mg/m2	Route: intravenous	once over 60 Minutes for 1 dose			Offset: 1.5 Hours	Instructions:	Infuse IV over 60 minutes starting 1.5 hours after treatment start time.  Stable for 24 hours at room temperature (36 hours refrigerated).  

HAZARDOUS - Handle with care	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-CYCLOPHOSPHAMIDE 500 MG IV POWDER FOR SOLN (M20-621/PRO00037811/PINGALI)	Medications	750 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes			  	INV-RiTUXimab (M20-621/Pro00037811/Pingali) 375 mg/m2 in sodium chloride 0.9% INFUSION	Dose: 375 mg/m2	Route: intravenous	once for 1 dose			Offset: 2 Hours	Instructions:	Initiate infusion at rate of 50 mg/hour.  In the absence of infusion toxicity (SBP within 20 mmHG of baseline, PULSE between 60 and 120 and TEMP less than 38 degrees C, and no symptoms), then increase infusion rate by 50 mg/hour every 30 minutes, to a maximum rate of 400 mg/hour.  
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS  (M20-621/PRO00037811/PINGALI)	Medications	375 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	 	Yes	Yes				Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 2	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Supportive Care
  	pegfilgrastim-jmdb (FULPHILA) injection (RESTRICTED)	Dose: 6 mg	Route: subcutaneous	once for 1 dose	Start: S						Day 8	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 15	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Imaging
  	PET CT WHOLE BODY	Interval: --	Occurrences: --	Comments:	*Up to 7 days prior to Cycle 5 Day 1

PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required. 
Once a subject has two consecutive CMR (at Cycle 4 and Week 28), imaging modality may be changed to CECT or MRI only at PI's discretion. PET scan must be performed for any new response of CR in absence of new anti-lymphoma treatment or PD obtained by CECT or MRI only.
		  	MRI WHOLE BODY WO	Interval: --	Occurrences: --	Comments:	*Up to 7 days prior to Cycle 5 Day 1
PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required. 
Once a subject has two consecutive CMR (at Cycle 4 and Week 28), imaging modality may be changed to CECT or MRI only at PI's discretion. PET scan must be performed for any new response of CR in absence of new anti-lymphoma treatment or PD obtained by CECT or MRI only.
		  	MRI BRAIN W WO CONTRAST	Interval: --	Occurrences: --			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 5	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	PGIC

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dispense Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Collect and review Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood NGS
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood ctDNA (MRD)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood for exploratory biomarkers
			Appointment Requests
  	IR LUMBAR PUNCTURE	Interval: --	Occurrences: --	Comments:	Collect prior to any intrathecal MTX (on or after C5D1)
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Only for subjects deemed to be at high-risk for CNS relapse at baseline
Screening (when lumber puncture is indicated to rule out CNS involvement)
Prior to any intrathecal MTX administration (on or after C5D1)
Any subject for whom a lumber puncture is performed during the study for CNS disease work-up
As clinically indicated.
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	ADA/nAb
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Take-Home Medications Prior to Treatment
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	The prednisone will be taken from the patient's supply that was dispensed through IDS pharmacy at HMH with PO 100 mg daily for 5 days.
			Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-VinCRIStine (M20-621/PRO00037811/PINGALI) 1.4 mg/m2 in sodium chloride 0.9% 50 mL	Dose: 1.4 mg/m2	Route: intravenous	once over 15 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Infuse IV over 15 minutes starting 30 minutes after treatment start time.  

Protect from light, VESICANT. 
Max dose = 2mg.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (M20-621/PRO00037811/PINGALI)	Medications	1.4 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	50 mL	Yes	Yes			  	INV-DOXOrubicin (M20-621/PRO00037811/PINGALI) 50 mg/m2 in sodium chloride 0.9% 100 mL	Dose: 50 mg/m2	Route: intravenous	once over 10 Minutes for 1 dose			Offset: 60 Minutes	Instructions:	Infuse IV over 10 minutes once, starting 60 minutes after treatment start time.  

Protect from light; VESICANT.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-DOXORUBICIN 50 MG INTRAVENOUS SOLN (M20-621/PRO00037811/PINGALI)	Medications	50 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			  	INV-cycloPHOSphamide (M20-621/PRO00037811/PINGALI) 750 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 750 mg/m2	Route: intravenous	once over 60 Minutes for 1 dose			Offset: 1.5 Hours	Instructions:	Infuse IV over 60 minutes starting 1.5 hours after treatment start time.  Stable for 24 hours at room temperature (36 hours refrigerated).  

HAZARDOUS - Handle with care	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-CYCLOPHOSPHAMIDE 500 MG IV POWDER FOR SOLN (M20-621/PRO00037811/PINGALI)	Medications	750 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes			  	INV-RiTUXimab (M20-621/Pro00037811/Pingali) 375 mg/m2 in sodium chloride 0.9% INFUSION	Dose: 375 mg/m2	Route: intravenous	once for 1 dose			Offset: 2 Hours	Instructions:	Initiate infusion at rate of 50 mg/hour.  In the absence of infusion toxicity (SBP within 20 mmHG of baseline, PULSE between 60 and 120 and TEMP less than 38 degrees C, and no symptoms), then increase infusion rate by 50 mg/hour every 30 minutes, to a maximum rate of 400 mg/hour.  
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS  (M20-621/PRO00037811/PINGALI)	Medications	375 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	 	Yes	Yes				Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 2	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Supportive Care
  	pegfilgrastim-jmdb (FULPHILA) injection (RESTRICTED)	Dose: 6 mg	Route: subcutaneous	once for 1 dose	Start: S							
Cycle 6	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	PGIC

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dispense Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Collect and review Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	CYTOMEGALOVIRUS (CMV), QUANTITATIVE, PLASMA, PCR	Interval: --	Occurrences: --	Comments:	For subjects with a positive screening CMV PCR test that has not demonstrated viral clearance prior to C1D1, or for all subjects whose PCR test becomes positive at any time, then the CMV DNA PCR test should be repeated more frequently and CMV treatment initiated or continued as appropriate, per investigator's discretion and institutional SOC.
			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Appointment Requests
  	IR LUMBAR PUNCTURE	Interval: --	Occurrences: --	Comments:	Collect prior to any intrathecal MTX (on or after C5D1)
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Only for subjects deemed to be at high-risk for CNS relapse at baseline
Screening (when lumber puncture is indicated to rule out CNS involvement)
Prior to any intrathecal MTX administration (on or after C5D1)
Any subject for whom a lumber puncture is performed during the study for CNS disease work-up
As clinically indicated.
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	ADA/nAb
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Take-Home Medications Prior to Treatment
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	The prednisone will be taken from the patient's supply that was dispensed through IDS pharmacy at HMH with PO 100 mg daily for 5 days.
			Chemotherapy
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Patient will receive R-CHOP in combination with epcoritamab for 6 cycles followed by 2 additional cycles of epcoritamab (E + R-CHOP)
			Chemotherapy
  	INV-VinCRIStine (M20-621/PRO00037811/PINGALI) 1.4 mg/m2 in sodium chloride 0.9% 50 mL	Dose: 1.4 mg/m2	Route: intravenous	once over 15 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Infuse IV over 15 minutes starting 30 minutes after treatment start time.  

Protect from light, VESICANT. 
Max dose = 2mg.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (M20-621/PRO00037811/PINGALI)	Medications	1.4 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	50 mL	Yes	Yes			  	INV-DOXOrubicin (M20-621/PRO00037811/PINGALI) 50 mg/m2 in sodium chloride 0.9% 100 mL	Dose: 50 mg/m2	Route: intravenous	once over 10 Minutes for 1 dose			Offset: 60 Minutes	Instructions:	Infuse IV over 10 minutes once, starting 60 minutes after treatment start time.  

Protect from light; VESICANT.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-DOXORUBICIN 50 MG INTRAVENOUS SOLN (M20-621/PRO00037811/PINGALI)	Medications	50 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			  	INV-cycloPHOSphamide (M20-621/PRO00037811/PINGALI) 750 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 750 mg/m2	Route: intravenous	once over 60 Minutes for 1 dose			Offset: 1.5 Hours	Instructions:	Infuse IV over 60 minutes starting 1.5 hours after treatment start time.  Stable for 24 hours at room temperature (36 hours refrigerated).  

HAZARDOUS - Handle with care	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-CYCLOPHOSPHAMIDE 500 MG IV POWDER FOR SOLN (M20-621/PRO00037811/PINGALI)	Medications	750 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes			  	INV-RiTUXimab (M20-621/Pro00037811/Pingali) 375 mg/m2 in sodium chloride 0.9% INFUSION	Dose: 375 mg/m2	Route: intravenous	once for 1 dose			Offset: 2 Hours	Instructions:	Initiate infusion at rate of 50 mg/hour.  In the absence of infusion toxicity (SBP within 20 mmHG of baseline, PULSE between 60 and 120 and TEMP less than 38 degrees C, and no symptoms), then increase infusion rate by 50 mg/hour every 30 minutes, to a maximum rate of 400 mg/hour.  
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS  (M20-621/PRO00037811/PINGALI)	Medications	375 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	 	Yes	Yes				Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 2	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Supportive Care
  	pegfilgrastim-jmdb (FULPHILA) injection (RESTRICTED)	Dose: 6 mg	Route: subcutaneous	once for 1 dose	Start: S							
Cycles 7,8	Repeat 2 times	Cycle length: 21 days	Day 1	Perform every 0 days x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	PGIC

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	CRS prophylaxis and temperature monitoring
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dispense Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Collect and review Subject Diary
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Clinical requirements for
administration of epcoritamab
assessment
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood NGS
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood ctDNA (MRD)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood for exploratory biomarkers
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	ADA/nAb
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Only for subjects deemed to be at high-risk for CNS relapse at baseline
Screening (when lumber puncture is indicated to rule out CNS involvement)
Prior to any intrathecal MTX administration (on or after C5D1)
Any subject for whom a lumber puncture is performed during the study for CNS disease work-up
As clinically indicated.
			Appointment Requests
  	IR LUMBAR PUNCTURE	Interval: --	Occurrences: --	Comments:	Collect prior to any intrathecal MTX (on or after C5D1)
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Administer 30 minutes prior to chemotherapy.		  	sodium chloride 0.9 % infusion	Dose: 250 mL/hr	Route: intravenous	continuous over 60 Minutes			Offset: 0 Hours	Instructions:	Concomitant fluids.		  	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous		Start: S				  	sodium chloride 0.9 % infusion	Dose: 1,000 mL/hr	Route: intravenous	continuous	Start: S					Take-Home Medications Prior to Treatment
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	The prednisone will be taken from the patient's supply that was dispensed through IDS pharmacy at HMH with PO 100 mg daily for 5 days.
			Chemotherapy
  	INV-EPCORITAMAB (M20-621/PRO00037811/PINGALI) subcutaneous injection 48 mg	Dose: 48 mg	Route: subcutaneous	once for 1 dose	Start: S			Instructions:	Inject required dose volume into the tissue of the lower part of the abdomen (preferred site) or the thigh. Rotate injection site from left to right (or vice versa), particularly during the weekly administrations (in cycles 1 to 3). Do not inject into tattoos or scars, or areas where the skin is red, bruised, tender, hard, or not intact. Administer immediately, or stable for 12 hours refrigerated.
HAZARDOUS - Handle with care / Protect from light / Do NOT tube OR shake			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Unscheduled ( as needed )	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Except for C1D1 dosing, these laboratories must be obtained within 3 days (preferably on the day prior) of each study drug administration
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Local labs: Blood must be collected into prechilled tubes containing heparin anticoagulant. Immediately immerse plasma samples for uric acid measurement in an ice water bath. Plasma samples should be prepared by centrifugation in a precooled centrifuge (4°C). If a precooled centrifuge (4°C) is not available, then the plasma sample should be centrifuged while cold. Finally, the plasma must be maintained in an ice water bath and analyzed for uric acid within 4 hours of collection.
		  	CALCIUM LEVEL	Interval: --	Occurrences: --		  	CREATININE LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	POTASSIUM LEVEL	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --			Labs
  	CYTOMEGALOVIRUS (CMV), QUANTITATIVE, PLASMA, PCR	Interval: --	Occurrences: --	Comments:	For subjects with a positive screening CMV PCR test that has not demonstrated viral clearance prior to C1D1, or for all subjects whose PCR test becomes positive at any time, then the CMV DNA PCR test should be repeated more frequently and CMV treatment initiated or continued as appropriate, per investigator's discretion and institutional SOC.
			Imaging
  	TTE COMPLETE, WO CONTRAST, WO DOPPLER	Interval: --	Occurrences: --		  	ZZ_HIST_NM CARDIAC BLOOD POOL MUGA (AT REST)	Interval: --	Occurrences: --			Imaging
  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	ECG to be obtained prior to the blood collection.  ECGs occurring near meals will take place prior to meals. Acquired after the subject has been in the supine position for at least 5 minutes
			Imaging
  	PET CT WHOLE BODY	Interval: --	Occurrences: --	Comments:	*Up to 7 days prior to Cycle 5 Day 1

PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required. 
Once a subject has two consecutive CMR (at Cycle 4 and Week 28), imaging modality may be changed to CECT or MRI only at PI's discretion. PET scan must be performed for any new response of CR in absence of new anti-lymphoma treatment or PD obtained by CECT or MRI only.
		  	MRI WHOLE BODY WO	Interval: --	Occurrences: --	Comments:	*Up to 7 days prior to Cycle 5 Day 1
PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required. 
Once a subject has two consecutive CMR (at Cycle 4 and Week 28), imaging modality may be changed to CECT or MRI only at PI's discretion. PET scan must be performed for any new response of CR in absence of new anti-lymphoma treatment or PD obtained by CECT or MRI only.
		  	MRI BRAIN W WO CONTRAST	Interval: --	Occurrences: --			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
					
End of Treatment (EOT)	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Collect and review Subject Diary
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN M	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Labs
  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --		  	FIBRINOGEN	Interval: --	Occurrences: --			Labs
  	CYTOMEGALOVIRUS (CMV), QUANTITATIVE, PLASMA, PCR	Interval: --	Occurrences: --	Comments:	For subjects with a positive screening CMV PCR test that has not demonstrated viral clearance prior to C1D1, or for all subjects whose PCR test becomes positive at any time, then the CMV DNA PCR test should be repeated more frequently and CMV treatment initiated or continued as appropriate, per investigator's discretion and institutional SOC.
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
			Imaging
  	PET CT WHOLE BODY	Interval: --	Occurrences: --	Comments:	*Up to 7 days prior to Cycle 5 Day 1

PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required. 
Once a subject has two consecutive CMR (at Cycle 4 and Week 28), imaging modality may be changed to CECT or MRI only at PI's discretion. PET scan must be performed for any new response of CR in absence of new anti-lymphoma treatment or PD obtained by CECT or MRI only.
		  	MRI WHOLE BODY WO	Interval: --	Occurrences: --	Comments:	*Up to 7 days prior to Cycle 5 Day 1
PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required. 
Once a subject has two consecutive CMR (at Cycle 4 and Week 28), imaging modality may be changed to CECT or MRI only at PI's discretion. PET scan must be performed for any new response of CR in absence of new anti-lymphoma treatment or PD obtained by CECT or MRI only.
		  	MRI BRAIN W WO CONTRAST	Interval: --	Occurrences: --					
120-day Safety Follow-up	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	ECOG Performance Standards.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms (B symptoms).

Assessment for the presence of drenching night sweats, unintentional weight loss of > 10% of body mass in the previous 6 months and/or fever > 38°C without identifiable cause
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Neurological (ICANS) assessment
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	CYTOMEGALOVIRUS (CMV), QUANTITATIVE, PLASMA, PCR	Interval: --	Occurrences: --	Comments:	For subjects with a positive screening CMV PCR test that has not demonstrated viral clearance prior to C1D1, or for all subjects whose PCR test becomes positive at any time, then the CMV DNA PCR test should be repeated more frequently and CMV treatment initiated or continued as appropriate, per investigator's discretion and institutional SOC.
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
					
Post-Treatment Follow-up	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Prior/concomitant medication.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Adverse events
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	New malignancy and new Anti-Lymphoma therapy
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Blood pressure, pulse, respiration, oximetry, and temperature
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Exam

Targeted physical examinations may be performed up to 3 days before the visit and should include evaluation of the treatment injection site, as applicable.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Constitutional symptoms
(B symptoms)
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Lymph node examination
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	EQ-5D-5L

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	FACT Lym 

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	PGIC

Self-administered prior to clinical assessments, dosing, or any other procedures on visits specified.
			Labs
  	HCG QUALITATIVE, URINE SCREEN	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	ABSOLUTE NEUTROPHIL COUNT	Interval: --	Occurrences: --		  	ABSOLUTE LYMPHOCYTE COUNT	Interval: --	Occurrences: --		  	ZZANTI-HU	Interval: --	Occurrences: --		  	EOSINOPHIL COUNT ABSOLUTE	Interval: --	Occurrences: --		  	ABSOLUTE BASOPHILS COUNT	Interval: --	Occurrences: --		  	NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Absolute Blast count (if present)
			Labs
  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	TRIGLYCERIDES	Interval: --	Occurrences: --			Imaging
  	CT HEAD W WO CONTRAST	Interval: --	Occurrences: --	Comments:	PET/CT

PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required.
		  	MRI WHOLE BODY WO	Interval: --	Occurrences: --	Comments:	CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required.
		  	MRI BRAIN W WO CONTRAST	Interval: --	Occurrences: --	Comments:	Brain MRI/CECT and lumbar puncture for subjects with high-risk for CNS involvement or as clinically indicated. Local flow cytometry (preferred) or cytology and CSF samples sent centrally
			Imaging
  	PET CT WHOLE BODY	Interval: --	Occurrences: --	Comments:	*Up to 7 days prior to Cycle 5 Day 1

PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required. 
Once a subject has two consecutive CMR (at Cycle 4 and Week 28), imaging modality may be changed to CECT or MRI only at PI's discretion. PET scan must be performed for any new response of CR in absence of new anti-lymphoma treatment or PD obtained by CECT or MRI only.
		  	MRI WHOLE BODY WO	Interval: --	Occurrences: --	Comments:	*Up to 7 days prior to Cycle 5 Day 1
PET-CT with contrast enhancement is required. If the CT component of the PET-CT scan is not of diagnostic quality, a standalone, contrast-enhanced CT or MRI scan is required.  CT coverage of the neck, chest, abdomen, pelvis, and any other disease sites is required. 
Once a subject has two consecutive CMR (at Cycle 4 and Week 28), imaging modality may be changed to CECT or MRI only at PI's discretion. PET scan must be performed for any new response of CR in absence of new anti-lymphoma treatment or PD obtained by CECT or MRI only.
		  	MRI BRAIN W WO CONTRAST	Interval: --	Occurrences: --			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	TBNK (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (by flowcytometry)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Immuno-phenotyping (exploratory)
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Cytokine (soluble factors)

EDTA Serum - Cytokine/Chemokine Panels
			Pharmacokinetic Instructions
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood NGS
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood ctDNA (MRD)
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Whole blood for exploratory biomarkers
			Procedures
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Fresh Tumor Biopsy.
If patient consented for 'optional' procedure. At time of progression.
					
Survival Follow-up	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 0 days x1		Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies.See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelins.
		  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Epcoritamab Treatment: Refer to Section 6.2 Toxicity Management, Dose Modifications, and Safety Management
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	New malignancy and new Anti-Lymphoma therapy
		  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Survival Status