HSCT planning Mexico

door Sterker dan MS

~ Indicatief maandoverzicht – aHSCT behandeling in Mexico ~

Het volgende overzicht geeft van dag tot dag weer wat er gepland staat tijdens de aHSCT behandeling in Mexico. Hier en daar kan er iets verschuiven, maar het geeft zeker een goede indicatie weer van wat er te verwachten staat. De transplantatie-dag wordt “Dag 0” genoemd. De dagen ervoor worden als minus aangegeven en daarna tellen de dagen weer op.
De dagen die ingevuld staan zijn fictief, maar dit schema kan eenvoudig overgenomen worden vanaf de eigen startdatum.

 

Een beknopt overzicht van de aHSCT behandeling in Mexico versus de behandeling in Moskou staat helemaal onderaan de pagina.

Dag -12 | Maandag
Tijd Programma Locatie Opmerking
07:30 Lab tests (blood and urine samples) Center for Outpatient Residents (1st floor) Fasting is required: 8 hrs without food or water
09:00 Welcome Center for Outpatient Residents (1st floor)
11:00 Spirometry test Center for Outpatient Residents (1st floor)
11:30 CXR Laboratorios Ruiz (La Paz)
– Consultation with neurologist Center for Outpatient Residents (1st floor) Patient must bring MRI images and reports to neurologist evaluation.
17:00 Consultation with cardiologist (Electrocardiogram) Hospitales Angeles (1065)
Dag -11 | Dinsdag
Tijd Programma Locatie Opmerking
11:30 Medical history Hematology Center
12:00 Hematology consultation Hematology Center
13:00 Intravenous Cyclophosphamide (chemotherapy) Hematology Center 5 hr duration
Instructions during chemotherapy:
– No food or drinks are allowed inside the chemotherapy room (Patients may bring BOTTLED water only);
– Patients must bring their blanket as the temperature is kept low during the procedure;
– Internet is available
Dag -10 | Woensdag
Tijd Programma Locatie Opmerking
08:00 Intravenous Cyclophosphamide (chemotherapy) Hematology Center Patients must stay hydrated during the chemotherapy day. 3 Liters of water are recommended.
Dag -9 / -8 / -7 | Donderdag/Vrijdag/Zaterdag (3x identiek programma)
Tijd Programma Locatie Opmerking
Every 12 hours Filgrastim subcutaneous medication (stem cell mobilizer) Center for Outpatient Residents (1st floor) Patients must stay hydrated. A minimum of 2 liters of water will be necessary.
Instructions:A nurse or doctor will apply medication at the Center for Outpatient Residents (COR). For the morning shot please be on time at 8:00 am at the doctor’s office on the 1st floor and for the night shot at 7:00 pm.
Medication:
1. Dexamethasone (Alin) 1 tablet at 8:00 am
2. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
3. Pantoprazole (Prazolan) 1 tablet at 8:00 am
Dag -6 | Zondag
Tijd Programma Locatie Opmerking
Every 12 hours Filgrastim subcutaneous medication (stem cell mobilizer) Center for Outpatient Residents (1st floor) Patients must stay hydrated. A minimum of 2 liters of water will be necessary.
Instructions:A nurse or doctor will apply medication at the Center for Outpatient Residents (COR). For the morning shot please be on time at 8:00 am at the doctor’s office on the 1st floor and for the night shot at 7:00 pm.
Medication:
1. Dexamethasone (Alin) 1 tablet at 8:00 am
2. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
3. Pantoprazole (Prazolan) 1 tablet at 8:00 am
4. Itraconazole (Isox) 1 capsule at 8:00 am
5. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
6. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag -5 | Maandag
Tijd Programma Locatie Opmerking
Every 12 hours Filgrastim subcutaneous medication (stem cell mobilizer) Center for Outpatient Residents (1st floor) Patients must stay hydrated. A minimum of 2 liters of water will be necessary.
Instructions:A nurse or doctor will apply medication at the Center for Outpatient Residents (COR). For the morning shot please be on time at 8:00 am at the doctor’s office on the 1st floor and for the night shot at 7:00 pm.
Medication:
1. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
2. Pantoprazole (Prazolan) 1 tablet at 8:00 am
3. Itraconazole (Isox) 1 capsule at 8:00 am
4. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
5. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag -4 | Dinsdag
Tijd Programma Locatie Opmerking
Every 12 hours Filgrastim subcutaneous medication (stem cell mobilizer) Center for Outpatient Residents (1st floor) Patients must stay hydrated. A minimum of 2 liters of water will be necessary.
17:00 Information consult Center for Outpatient Residents (1st floor)
Instructions:A nurse or doctor will apply medication at the Center for Outpatient Residents (COR). For the morning shot please be on time at 8:00 am at the doctor’s office on the 1st floor and for the night shot at 7:00 pm.
Medication:
1. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
2. Pantoprazole (Prazolan) 1 tablet at 8:00 am
3. Itraconazole (Isox) 1 capsule at 8:00 am
4. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
5. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag -3 | Woensdag
Tijd Programma Locatie Opmerking
Every 12 hours Filgrastim subcutaneous medication (stem cell mobilizer) Center for Outpatient Residents (1st floor)
08:00 Catheter placement Hospital Puebla Fasting is required: 8 hrs without food or water
Instructions:A nurse or doctor will apply medication at the Center for Outpatient Residents (COR). For the morning shot please be on time at 8:00 am at the doctor’s office on the 1st floor and for the night shot at 7:00 pm.
Medication:
1. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
2. Pantoprazole (Prazolan) 1 tablet at 8:00 am
3. Itraconazole (Isox) 1 capsule at 8:00 am
4. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
5. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag -2 | Donderdag
Tijd Programma Locatie Opmerking
09:30 Apheresis, cell harvesting Hematology Center – At 7:00 you can eat and drink: 1 glass of water, 1 granola bar, 1 piece of fruit.
– Duration +/- 4 hours.
14:00 Intravenous Cyclophosphamide and Mesna (chemotherapy) Hematology Center Patients must stay hydrated during the chemotherapy day. 3 Liters of water are recommended.
– 5 hour duration.
Instructions Ahperesis:

  • In the Apheresis room patients must use diapers during the stem cell collection due to hygienic reasons. Please bring your own diaper. The machine cannot be disconnected or paused.
  • No food or drinks are allowed in the Apheresis room (Patients may bring BOTTLED water only);
  • Patients mus wear comfortable clothes. Loose shirts are advised (no polos);
  • The procedure as an approximate duration of 4 hours;
  • Caregivers are not allowed to accompany patients inside the apheresis room. They are to remain in the assigned waiting rooms and will be called only if needed;
  • Patients must bring a blanket as the rooms remain at low temperatures during the procedure;
  • This is a long day. Come prepared to remain at clinic for approx. 12 hours;
  • Internet is available
Medication:
1. Pantoprazole (Prazolan) 1 tablet at 8:00 am
2. Itraconazole (Isox) 1 capsule at 8:00 am
3. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
4. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag -1 | Vrijdag
Tijd Programma Locatie Opmerking
09:00 Intravenous Cyclophosphamide and Mesna (chemotherapy) Hematology Center Patients must stay hydrated during the chemotherapy day. 3 Liters of water are recommended.
– 5 hour duration.
Instructions Chemotherapy room:

  • No food or drinks are allowed in the Apheresis room (Patients may bring BOTTLED water only);
  • Patients must bring a blanket as the rooms remain at low temperatures during the procedure;
  • Internet is available
Medication:
1. Pantoprazole (Prazolan) 1 tablet at 8:00 am
2. Itraconazole (Isox) 1 capsule at 8:00 am
3. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
4. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag 0 | Zaterdag
Tijd Programma Locatie Opmerking
11:30 Transfusion, cell placement Hematology Center – Neutropenic recommendations until recovery;
– Patients must stay hydrated. A minimum of 2 liters of water will be necessary.
Medication:
1. Dexamethasone (Alin) 1 tablet at 8:00 am
2. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
3. Pantoprazole (Prazolan) 1 tablet at 8:00 am
4. Itraconazole (Isox) 1 capsule at 8:00 am
5. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
6. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag +1 | Zondag
Tijd Programma Locatie Opmerking
– Neutropenic recommendations until recovery;
– Patients must stay hydrated. A minimum of 2 liters of water will be necessary.
Medication:
1. Dexamethasone (Alin) 1 tablet at 8:00 am
2. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
3. Pantoprazole (Prazolan) 1 tablet at 8:00 am
4. Itraconazole (Isox) 1 capsule at 8:00 am
5. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
6. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag +2 / +4 / +6 / +8 / +10 | Maandag/Woensdag/Vrijdag/Zondag/Dinsdag
Tijd Programma Locatie Opmerking
08:00 – Blood samples
– Filgrastim injection
– Hematology consultation		 Center for Outpatient Residents (1st floor) – Neutropenic recommendations until recovery;
– Patients must stay hydrated. A minimum of 2 liters of water will be necessary.
Medication:
1. Dexamethasone (Alin) 1 tablet at 8:00 am
2. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
3. Pantoprazole (Prazolan) 1 tablet at 8:00 am
4. Itraconazole (Isox) 1 capsule at 8:00 am
5. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
6. Acyclovir (Isavir) 1 tablet at 8:00 am
Dag +3 / +5 / +7 / +9 | Dinsdag/Donderdag/Zaterdag/Maandag
Instructions:
– Neutropenic recommendations until recovery;
– Patients must stay hydrated. A minimum of 2 liters of water will be necessary.
Medication:
1. Dexamethasone (Alin) 1 tablet at 8:00 am
2. Ondansetron (Amal) 1 tablet at 8:00 am and at 8:00 pm
3. Pantoprazole (Prazolan) 1 tablet at 8:00 am
4. Itraconazole (Isox) 1 capsule at 8:00 am
5. Trimetoprim / Sulfametoxazole (Bactrim) 1 tablet at 8:00 am
6. Acyclovir (Isavir) 1 tablet at 8:00 am
7. Filgrastim injection at 8:00
Dag +10  |  RITUXIMAB infusion
The established date for your group to receive Rituximab will be scheduled depending on your recovery. Please remember to bring the medical kit that we provided the first day. In case you are no recovered by now, blood samples and Filgrastim will be scheduled if needed. A doctor or staff will evaluate your progress and communicate to let you know what your schedule is for this week. The application of Rituximab will be scheduled accordingly.

~ Fasen van de aHSCT behandeling in Mexico ~

Samengevat komt het erop neer dat de aHSCT behandeling in Mexico uit de onderstaande fasen bestaat. Zowel in Rusland als in Mexico worden HSCT protocollen gebruikt met Rituximab. Om die reden hebben we de fasen van Mexico en Rusland ter vergelijking naast elkaar gezet.

~ HSCT fasen in Mexico ~ versus ~ HSCT fasen in Rusland ~
Dag 1 Onderzoeken en definitieve beslissing Dag 1-4 Onderzoeken en definitieve beslissing
Dag 2-3 Hoge dosis immunosuppressie / chemo 2 dagen geen chemo voor de stamcel mobilisatie
Dag 4-10 Stamcel mobilisatie (Filgrastim injecties) 7 dagen Dag 5-8 Stamcel mobilisatie (Filgrastim injecties) 4 dagen
Dag 11 Stamcellen oogsten. Stamcellen worden gekoeld. 1 dag Dag 8-9 Stamcellen oogsten. Stamcellen worden ingevroren na stamcelselectie in het lab. 1 a 2 dagen
Dag 11-12 Hoge dosis immunosuppressie / chemo 2 dagen Dag 9-12 Hoge dosis immunosuppressie / chemo 4 dagen
Dag 13 Stamcel transplantatie Dag 13 Stamcel transplantatie
Dag 14- Hematologisch en immunologisch herstel – isolatie periode Dag 14-27 Hematologisch en immunologisch herstel – isolatie periode
Dag ? Rituximab infuus en ontslag uit het ziekenhuis Dag 29-30 Rituximab infuus en ontslag uit het ziekenhuis
~ Thuis ~
Dag 30-365 Revalidatie + Consolidatiebehandeling voor risicogroep Dag 30-365 Revalidatie + Consolidatiebehandeling voor risicogroep
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