Home, Search, Index, Links, Pathology, Molecules, Syndromes, Muscle, NMJ, Nerve, Spinal, Ataxia, Antibody & Biopsy, Patient Info

Fludarabine Infusion Protocol

• Encephalopathy
  • Blindness
  • Coma
  • Death
• Bone marrow suppression: Anemia, Thrombocytopenia Neutropenia

Fludarabine

1. Patient is admitted for treatment by staff.
2. On admission
   • Vital signs: Obtain on initial evaluation and Hourly during infusion
   • Height and weight: Measure for Fludarabine dose calculation.
3. Patient is evaluated by a study physician: Obtain
   • Interval history
   • Pertinent physical exam
   • Adverse events
4. Quantitative dynamometry: On first and last visit; Performed by Dr Pestronk
5. Laboratory
   • Blood: CBC and electrolytes, glucose, and creatinine (BMP)
   • First and last admissions: Blood is also drawn for
     • Antibody titers to GM1 ganglioside or MAG: 2 red top tubes to Room 404 IWJ
     • Immunocompetency panel: Send for CD3, CD19
     • Quantitative immunoglobulins

1. Start IV heparin lock
2. Start normal saline at 100 cc/hr
3. Run saline at keep vein open (kvo) rate during infusion

• Fludarabine dose: 25 mg/M². Calculate absolute dose to be administered.
• Fludarabine Infusion: Over 30 minutes
• Patients may take all regular medicines while in hospital.

1. Problems: Contact the Neuromuscular fellow immediately.
   • A fellow is available 24 hours a day
   • Phone #: 388-6138
2. Notify fellow for
   • Temp > 38.0
   • Cardiac complaints
   • Respiratory symptoms: Shortness of breath must be reported immediately.
   • Encephalopathy: Mental status change; Visual loss
   • Rash
3. Activity while in hospital: Patient may be up ad lib

1. Patient should be sent home on their regular medicines
2. Follow-up: 2 months after final infusion in the Neuromuscular clinic.
3. Questions or problems: Patient should call Neuromuscular office at 314-362-6981.