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Utility: This protocol is for use in patients with motor and anti-MAG neuropathies.

Treatment regimen: During each cycle of treatment patients receive plasma exchange (1.5 plasma volumes) with 5% albumin replacement on two consecutive days. This is followed by hydration (1 to 1.5 liters), then 1g/M2 of cyclophosphamide given intravenously over 3 to 4 hours, and, finally, further hydration (1 to 1.5 liters).

During a course of therapy this regimen is given 6 times, one every 4 weeks. The patient is treated with cyclophosphamide (Cytoxan), a total of 1.0 gm/M2 intravenously over a period of 3 hours. Patients should be otherwise healthy and without evidence of infection for the prior 1-2 weeks. The protocol should probably be modified in debilitated patients.

Precautions taken to avoid side effects include:
  1. Fluid: Administration of 3-4 liters of fluid on the days of Cytoxan treatment.
  2. Antiemetics - Zofran (Ondansetron) 0.15 mg/kg over 15 minutes: Give
  3. Strict I&O should be kept during the patient's hospital stay.
  4. Urine: During and 1 day after treatment
  5. After administration of Cytoxan, IV tubing should be changed before resuming regular IV hydration.
  6. Blood tests: Obtained before the first plasma exchange and at intervals thereafter.
  7. Follow-up - Return outpatient appointment is 1 to 2 months after the last treatment.
  8. Nursing precautions should include:

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