Canterbury DHB


Cytotoxic Schedules and Choice of Antiemetics

Highly Emetogenic (HEC)

Moderately Emetogenic (MEC)

Low Emetogenic (LEC)


Cytotoxic Schedule

Choice of Antiemetic Protocol (HEC, MEC, or LEC)

Standard Allograft SCT Conditioning

  • Cy/TBI - use HEC protocol throughout.
  • Bu/Cy - use HEC protocol on cyclophosphamide days and for 2 days after. Use LEC protocol on other days.

RIC Allo SCT Conditioning

  • Flu/Mel/Alemtuzumab - use LEC on each day of fludarabine. Use MEC protocol starting on the day of melphalan.

Standard Autologous Conditioning

  • BEAM - use HEC protocol on day -6 to -4 then MEC protocol day -4 to day +1.
  • High Dose Melphalan - use MEC protocol day -1 to day +1.

Cyclophosphamide for Stem Cell Harvest

  • Use MEC protocol.

AML (DA, ADE, HDAC, FLAG, Ida-Cytarabine, MiDAC)

  • Use MEC protocol without dexamethasone first line.


  • Use MEC protocol (without dexamethasone as CHOP contains high dose prednisone).


  • Use LEC on day 1 of chemo.
  • Use MEC from day 2 onwards (when carboplatin starts).

Hyper CVAD and MTX-Cytarabine

  • Use MEC protocol.

CODOX-M Regimen

  • Use MEC protocol day 1-12.


  • Use MEC protocol day 1-7.

High dose Methotrexate

  • Use MEC protocol.

UKALL12 Induction 1

  • Use the 3 day MEC protocol (without dexamethasone as high dose prednisone is being given) starting each time with daunorubicin on day 1,8,15,22.

UKALL12 Induction 2

  • Use 3 day MEC protocol starting with each cylophosphamide on days 1,15,29.
  • Use LEC protocol on other days.

Note: Chemotherapy charts include both the cytotoxic drugs used plus the appropriate antiemetic supportive care required.

About this Canterbury DHB document (9327):

Document Owner:

Sean Macpherson (see Who's Who)

Last Reviewed:

January 2019

Next Review:

January 2022


Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 9327