ProtocolDraft — not reviewed
Dosing safety checks
BSA vs weight banding, organ-function adjustment and the double-check chain.
- BSA (Mosteller)
- √(height cm × weight kg / 3600)
- Weight-based rule
- Usually <12 kg or <1 year — check protocol
- Vincristine cap
- Commonly 2 mg — protocol dependent
Before the dose
- Confirm current weight and height measured this cycle, not carried forward.
- Confirm the roadmap day, cycle number and any prescribed dose modification.
- Independent double-check of calculation, drug, route and diluent by a second qualified practitioner.
- Intrathecal drugs: separate time, separate room, separate checking process. Never in the same tray as IV vincristine.
Escalate
- Any dose >10% different from the previous cycle without a documented reason — stop and query with pharmacy.
Organ-function adjustment
- Renal: methotrexate, cisplatin, carboplatin, ifosfamide — check GFR method required by protocol.
- Hepatic: vincristine, anthracyclines — adjust on bilirubin per protocol table.
- Cardiac: cumulative anthracycline tracked in mg/m² doxorubicin-equivalents with scheduled echo.
- Ototoxicity monitoring for platinum agents before each course.
Sources and local override
- Institutional chemotherapy prescribing policy — Caps, rounding rules and double-check rules are local.
Next review due 2027-02-01.