PROTOKOL KEMOTERAPI WILMS TUMOR STAGE III IV FAVORABLE HYSTOLOGY, STAGE I III FOCAL ANAPLASTIC, STAGE I DIFFUSE ANAPLASTIC

IC AMD VCR 1 VCR 2 DOX 1 DOX 2 MINGG U 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

VCR1 : Vincristine 0.025 mg/kg/day for 1 day IV for infants <12 months 0.05 mg/kg/day for 1 day IV for children 12 months & 30 kg 1.5 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2 mg) VCR2 : Vincristine 0.034mg/kg/day for 1 day IV for infants <12 months 0.067 mg/kg/day for 1 day IV for children 12 months & 30 kg 2 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2 mg) AMD : Actinomycin-D 0.023mg/kg/day for 1 day IV for infants <12 months 0.045 mg/kg/day for 1 day IV for children 12 months & 30 kg 1.35 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2.3 mg) DOX1 : Doxorubicin 0.75 mg/kg/day for 1 day IV for infants <12 months 1.5 mg/kg/day for 1 day IV for children 12 months & 30 kg 45 mg/m2/day for 1 day IV for children >30 kg DOX2 : Doxorubicin 0.5 mg/kg/day for 1 day IV for infants <12 months 1 mg/kg/day for 1 day IV for children 12 months & 30 kg 30 mg/m2/day for 1 day IV for children >30 kg

Mengetahui Supervisor Hemato-Onkologi Anak

Dr. Firman Arbi SpA(K)

PROTOKOL KEMOTERAPI WILMS TUMOR STAGE III IV FAVORABLE HYSTOLOGY, STAGE I III FOCAL ANAPLASTIC, STAGE I DIFFUSE ANAPLASTIC AMD VCR 1 VCR 2 DOX 1 DOX 2 MINGG U 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

VCR1 : Vincristine 0.025 mg/kg/day for 1 day IV for infants <12 months 0.05 mg/kg/day for 1 day IV for children 12 months & 30 kg 1.5 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2 mg) VCR2 : Vincristine 0.034mg/kg/day for 1 day IV for infants <12 months 0.067 mg/kg/day for 1 day IV for children 12 months & 30 kg 2 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2 mg) AMD : Actinomycin-D 0.023mg/kg/day for 1 day IV for infants <12 months 0.045 mg/kg/day for 1 day IV for children 12 months & 30 kg 1.35 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2.3 mg) DOX1 : Doxorubicin 0.75 mg/kg/day for 1 day IV for infants <12 months 1.5 mg/kg/day for 1 day IV for children 12 months & 30 kg 45 mg/m2/day for 1 day IV for children >30 kg DOX2 : Doxorubicin 0.5 mg/kg/day for 1 day IV for infants <12 months 1 mg/kg/day for 1 day IV for children 12 months & 30 kg 30 mg/m2/day for 1 day IV for children >30 kg

Mengetahui Supervisor Hemato-Onkologi Anak

Dr. Amirah Zatil Izzah SpA

PROTOKOL KEMOTERAPI WILMS TUMOR STAGE IV FOCAL ANAPLASTIC & STAGE II IV DIFFUSE ANAPLASTIC WILMS TUMOR DOX VCR 1 VCR 2 CTX 5 CTX 3 ETOP MINGG U 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

DOX : Doxorubicin CTX3 : Cyclophosphamide 0.75 mg/kg/day for 1 day IV for infants <12 months 7.35 mg/kg/day IV for 3 days for infants <12 months 1.5 mg/kg/day for 1 day IV for children 12 months & 30 kg 14.7 mg/kg/day IV for 3 days for children 12 months & 30 kg 45 mg/m2/day for 1 day IV for children >30 kg 440 mg/m2/day IV for 3 days for children >30 kg VCR1 : Vincristine ETOP : Etoposide 1.65 mg/kg/day for 5 days for infants <12 months 0.025 mg/kg/day for 1 day IV for infants <12 months 3.3 mg/kg/day IV for 5 days for children 1 12 months & 30 kg 0.05 mg/kg/day for 1 day IV for children 12 months & 30 kg 100 mg/m2/day IV for 5 days for children >30 kg 1.5 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2 mg) VCR2 :Vincristine 0.034 mg/kg/day for 1 day IV for infants <12 months 0.067 mg/kg/day for 1 day IV for children 12 months & 30 kg 2 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2 mg) CTX5 : Cyclophosphamide 7.35 mg/kg/day IV for 5 days for infants <12 months 14.7 mg/kg/day IV for 5 days for children 12 months & 30 kg 440 mg/m2/day IV for 5 days for children >30 kg G-CSF (filgrastim) 5 mg/kg/day subcutaneous starting 24 hours after cyclophosphamide until the ANC is >2,000/L after the expected nadir Doses of DOX reduced 50% if given within 6 weeks of whole lung or whole abdominal radiation therapy Mengetahui Supervisor HematoOnkologi Anak

Dr. Amirah Zatil Izzah SpA

PROTOKOL KEMOTERAPI WILMS TUMOR STAGE IV FOCAL ANAPLASTIC & STAGE II IV DIFFUSE ANAPLASTIC WILMS TUMOR DOX VCR 1 VCR 2 CTX 5 CTX 3 ETOP MINGG U 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

DOX : Doxorubicin CTX3 : Cyclophosphamide 0.75 mg/kg/day for 1 day IV for infants <12 months 7.35 mg/kg/day IV for 3 days for infants <12 months 1.5 mg/kg/day for 1 day IV for children 12 months & 30 kg 14.7 mg/kg/day IV for 3 days for children 12 months & 30 kg 45 mg/m2/day for 1 day IV for children >30 kg 440 mg/m2/day IV for 3 days for children >30 kg VCR1 : Vincristine ETOP : Etoposide 1.65 mg/kg/day for 5 days for infants <12 months 0.025 mg/kg/day for 1 day IV for infants <12 months 3.3 mg/kg/day IV for 5 days for children 1 12 months & 30 kg 0.05 mg/kg/day for 1 day IV for children 12 months & 30 kg 100 mg/m2/day IV for 5 days for children >30 kg 1.5 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2 mg) VCR2 :Vincristine 0.034 mg/kg/day for 1 day IV for infants <12 months 0.067 mg/kg/day for 1 day IV for children 12 months & 30 kg 2 mg/m2/day for 1 day IV for children >30 kg (Maximum dose 2 mg) CTX5 : Cyclophosphamide 7.35 mg/kg/day IV for 5 days for infants <12 months 14.7 mg/kg/day IV for 5 days for children 12 months & 30 kg 440 mg/m2/day IV for 5 days for children >30 kg G-CSF (filgrastim) 5 mg/kg/day subcutaneous starting 24 hours after cyclophosphamide until the ANC is >2,000/L after the expected nadir Doses of DOX reduced 50% if given within 6 weeks of whole lung or whole abdominal radiation therapy Mengetahui Supervisor HematoOnkologi Anak

Dr. Firman Arbi SpA(K)