Table 2.

KS chemotherapy regimens feasible in Malawi

Agent	Dosage	*RR	Major side effects
Single agent vincristine	1.4 mg/m2 (max. 2 mg) 1× /week intravenous bolus (IV) over 1–2 minutes or as short intra venous infusion (IVI) over 10–15 minutes.	10–85%	Cumulative neurotoxicity May produce severe constipation Necrosis in case of extravasation
Single agent vinblastine	4–6 mg/m2 1× /week IV over 2–3 minutes or as IVI over 10–15 minutes	25–85%	Vinblastine-induced myelosuppression
Single agent bleomycin	15 mg single doses or 5 mg/day for 3 days every 2–3 weeks IM	10–75%	Give test dose of 1–2 units Must adjust dose for renal insufficiency Total lifetime dose should not exceed 400 units
Vincristine/ Vinblastine	Vincristine 1.4 mg/m2 (max. 2 mg) and vinblastine 0.1 mg/kg IV alternating weekly. Modality of administration as described for single agents	Up to 43%	As described for single agents
BV bleomycin/vincristine	Vincristine 1.4 mg/m2 (max. 2 mg) and bleomycin 10 mg/m2 every 2 weeks IV. Modality of administration for vincristine is as described for single agent. For bleomycin IV give slowly over a period of 10 minutes.	60–75%	As described for single agents
ABV doxorubicin/bleomycin/vincristine	Doxorubicin 20 mg/m2 ; bleomycin 15 units and vincristine 2 mg every 21 days. Administer vincristine and bleomycin IV as described previously. For doxorubicin push slowly through sidearm of free flowing IV normal saline or D5W This regimen may be given every 14 days but would increase the severity of side effects.	70–90%	Doxorubicin: cumulative dose not to exceed 450 mg/m2; assess cardiac function clinically or by ECG/ECHO before giving drug avoid extravasation; reduce dose by 50% if bilirubin 1.5 – 3.0; reduce to 25% for bilirubin > 3.0

Notes: * the response rates “RR” of various KS regimens are indicatory only as they were derived from different studies which did not necessarily use similar end-points