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Fludarabine Infusion Protocol

Possible severe side effects Encephalopathy Blindness Coma Death Bone marrow suppression: Anemia, Thrombocytopenia Neutropenia Admission testing Patient is admitted for treatment by staff. On admission Vital signs: Obtain on initial evaluation and Hourly during infusion Height and weight: Measure for Fludarabine dose calculation. Patient is evaluated by a study physician: Obtain Interval history Pertinent physical exam Adverse events Quantitative dynamometry: On first and last visit; Performed by Dr Pestronk 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 Neuromuscular Lab Immunocompetency panel: Send for CD3, CD19 Quantitative immunoglobulins IV Access Start IV heparin lock Start normal saline at 100 cc/hr Run saline at keep vein open (kvo) rate during infusion Fludarabine Infusions: 5 consecutive days each month x 6 months 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. Precautions Problems: Contact the Neuromuscular fellow immediately. A fellow is available 24 hours a day Phone #: 388-6138 Notify fellow for Temp > 38.0 Cardiac complaints Respiratory symptoms: Shortness of breath must be reported immediately. Encephalopathy: Mental status change; Visual loss Rash Activity while in hospital: Patient may be up ad lib Discharge Patient should be sent home on their regular medicines Follow-up: 2 months after final infusion in the Neuromuscular clinic. Questions or problems: Patient should call Neuromuscular office at 314-362-6981.

Fludarabine