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Burkitt's Lymphoma and Other Lymphoma SACT Regimens

Burkitt’s Lymphoma

R-CODOX-M Therapy (Patients less than or equal to 65 years)

Regimen

Indication

00398a

Treatment of Burkitt Lymphoma in patients less than or equal to 65 years.

R-CODOX-M Therapy (Patients greater than 65 years)

Regimen

Indication

00403a

Treatment of Burkitt Lymphoma in patients aged greater than 65 years.

R-IVAC Therapy Patients greater than 65 years

Regimen

Indication

00404a

Treatment of patients with extensive Burkitt Lymphoma aged greater than 65 years.

R-IVAC Therapy Patients less than or equal to 65 years

Regimen

Indication

00399a

Treatment of patients with extensive stage Burkitt Lymphoma aged less than or equal to 65 years.

Lymphoma Other (PCNSL, MCD, LLGL, MF, SS, CTCL)

riTUXimab, Methotrexate, Procarbazine and vinCRIStine (R-MPV) - 14 Days Induction Therapy

Regimen

Indication

00664a

Treatment of newly diagnosed primary CNS lymphoma (PCNSL)

High Dose Cytarabine Consolidation Therapy (post RMPV) - 28 day Therapy

Regimen

Indication

00666a

Consolidation chemotherapy for the treatment of patients with newly diagnosed primary CNS lymphoma (PCNSL)

High dose Methotrexate, high dose Cytarabine, riTUXimab and Thiotepa (MATRix)Therapy

Regimen

Indication

00508a

Treatment of primary CNS lymphoma

Siltuximab Monotherapy

Regimen

Indication

00277a

Treatment of adult patients with Multicentric Castleman’s disease (MCD) who are human immunodeficiency virus (HIV) negative and human herpes virus 8 (HHV-8) negative.

Mogamulizumab Therapy

Regimen

Indication

00761a

As monotherapy for the treatment of adult patients with mycosis fungoides (MF) or Sézary syndrome (SS) who have received at least one prior systemic therapy

Brentuximab vedotin Monotherapy

Regimen

Indication

00234d

Treatment of adult patients with CD30+ cutaneous T-cell lymphoma (CTCL) after at least 1 prior systemic therapy.

CHOEP Therapy - 21 days

Regimen

Indication

00396a

Treatment of T-cell Non-Hodgkin Lymphoma (NHL)

SMILE Therapy (NK or T cell Lymphoma)

Regimen

Indication

00407a

Newly diagnosed stage II - IV or relapsed/refractory extranodal natural killer/T-cell lymphoma