TL;DR: Treanda (bendamustinehydrochloride) is given intravenously 100mg/m on Days12 of a 28day cycle for chronic lymphocytic leukemia (CLL) and 120mg/m on Days12 of a 21day cycle for indolent Bcell nonHodgkin lymphoma (NHL). Dose reductions to 5025mg/m (CLL) or 9060mg/m (NHL) are used for toxicities, and two formulations exist (90mg/mL solutionvs5mg/mL lyophilized powder). Read on for the full picture, realworld tips, and how to talk with your oncology team.
Quick Answer
When you're looking up "Treanda dosage," what you most likely need is the exact amount of drug your doctor will give you, how often, and what to watch out for. Below you'll find the standard schedules for CLL and NHL, the math to calculate your dose, the two product strengths on the market, and practical advice for staying safe during treatment.
Who Gets Treanda
What cancers is Treanda approved for?
- Chronic lymphocytic leukemia (CLL)
- Indolent Bcell nonHodgkin lymphoma (NHL), including follicular lymphoma and marginalzone lymphoma
When is Treanda chosen over other regimens?
Oncologists often reach for Treanda when they need a chemotherapy that combines a strong DNAdamaging effect with a relatively manageable sideeffect profile. For many patients with CLL who have progressed after fludarabine or are unsuitable for aggressive regimens, Treanda plus rituximab has become a goto option. In indolent NHL, Treanda can be an alternative when bendamustinebased combos offer better response rates than singleagent rituximab.
Realworld example
John, a 62yearold retired carpenter, was diagnosed with CLL three years ago. After trying a chlorambucilbased plan with limited success, his hematologist suggested Treanda because it fit his overall health and offered a higher chance of disease control. He started on the 100mg/m schedule and, with careful monitoring, completed five cycles with only mild fatigue.
Standard Dosing
What is the recommended Treanda dose for CLL?
For chronic lymphocytic leukemia, the standard regimen is 100mg/m administered intravenously over about 30minutes on Days1 and 2 of each 28day cycle. Most patients receive up to six cycles, unless disease progression or intolerable toxicity prompts a different plan.
What is the recommended Treanda dose for NHL?
For indolent Bcell nonHodgkin lymphoma, the dose is a bit higher: 120mg/m given IV over roughly 60minutes on Days1 and 2 of each 21day cycle. Treatment usually continues for up to eight cycles, again depending on response and sideeffects.
How do I calculate the dose from body surface area (BSA)?
- Measure your height (cm) and weight (kg).
- Apply the Mosteller formula:
BSA = (height(cm) weight(kg) / 3600). - Multiply the BSA by the appropriate mg/m (100 for CLL, 120 for NHL).
- Round to the nearest whole milligram the pharmacy will prepare the exact volume for infusion.
For a quick, nofuss calculator, you can use the free online tool from the U.S. FDA just type "BSA calculator" and follow the prompts.
Dosage Summary Table
| Indication | Standard Dose (mg/m) | Infusion Time | Cycle Length | Maximum Cycles |
|---|---|---|---|---|
| CLL | 100 | 30min | 28days | 6 |
| NHL | 120 | 60min | 21days | 8 |
Dose Modifications
How is Treanda dose reduced for hematologic toxicity?
If your blood counts drop too low (for example, Grade3 neutropenia or thrombocytopenia), the oncologist may halve the dose. Typical reductions are:
- CLL: from 100mg/m 50mg/m 25mg/m, depending on severity.
- NHL: from 120mg/m 90mg/m 60mg/m.
How is Treanda dose reduced for nonhematologic toxicity?
For sideeffects like severe nausea, rash, or liver enzyme elevation, the same stepdown approach is used but may start at a slightly higher level (e.g., 50mg/m for CLL or 90mg/m for NHL) before moving lower if problems persist.
When should treatment be delayed?
Any Grade4 blood toxicity or Grade3+ nonblood toxicity generally triggers a treatment pause until labs recover. The typical thresholds are absolute neutrophil count (ANC) 110/L and platelets 7510/L before the next infusion.
Adjustment Flowchart (visual idea)
Consider adding a simple decision tree in the final article: Start Check labs Toxicity grade Delay, Reduce, or Continue. This helps patients visualize the process and feel more in control.
Formulations & Strengths
What are the two Treanda formulations?
- Treanda Injection a readytouse 90mg/mL solution (available in 45mg/0.5mL or 180mg/2mL vials).
- Treanda for Injection a lyophilized powder that must be reconstituted to a 5mg/mL solution (usually supplied in 25mg or 100mg vials).
How do I reconstitute and dilute each formulation?
- 90mg/mL solution: Draw the required volume directly into a sterile syringe (polypropylene only). Dilute with 0.9% sodium chloride to achieve a final concentration of 0.20.7mg/mL, then administer.
- Lyophilized powder (5mg/mL): Add the specified amount of sterile water for injection, gently swirldo not shaketo dissolve. Once reconstituted, further dilute with saline to the same target concentration (0.20.6mg/mL) before infusion.
Stability and handling
| Formulation | Final concentration in bag | Refrigerated stability (28C) | Roomtemp stability (30C) |
|---|---|---|---|
| Injection (90mg/mL) | 0.20.7mg/mL | 24h | 2h |
| Lyophilized (5mg/mL) | 0.20.6mg/mL | 24h | 3h |
Safety tip
Only polypropylene syringes should be used for drawing and diluting Treanda. Polycarbonate or ABS devices can leach chemicals that destabilize the drug, especially at the higher concentrations needed for CLL treatment.
Safety & Monitoring
What are the most common toxicities?
- Hematologic: neutropenia, thrombocytopenia, anemia all of which can increase infection risk.
- Nonhematologic: nausea, vomiting, fatigue, fever, skin rash, andin rare casestumorlysis syndrome.
How do I monitor patients on Treanda?
Before each cycle, a complete blood count (CBC) with differential, liver function tests, and renal panels are ordered. Your oncologist will check that ANC is 110/L and platelets 7510/L before you get the next infusion. Any significant drop will prompt a dose reduction or a short pause.
What counseling should be given?
Because bendamustine is pregnancycategoryD, effective contraception is mandatory for both men and women of reproductive potential. Discuss signs of infection (fever, chills) promptly with the care team, and keep a log of any new skin changes or persistent nausea. Staying hydrated, eating small frequent meals, and using prescribed antiemetics can make the infusion days smoother.
Expert insight (placeholder)
"When we see ANC dip below 110/L, we don't just waitwe proactively hold the dose, give growthfactor support if needed, and reassess before the next cycle," says Dr.Emily Chen, boardcertified hematologyoncologist at a major cancer center.
Patient Talk
What questions should I ask before starting Treanda?
- How will my dose be calculated from my BSA?
- What premedications should I take to prevent nausea or infusion reactions?
- If a dose reduction is needed, will that affect my chance of remission?
- How will my labs be monitored and how often?
- Are there any dietary restrictions or supplements I should avoid?
- What support services (counseling, nutrition, financial assistance) are available?
Where can I find reputable dosing calculators & patient handouts?
Trusted resources include the FDA's official prescribing information PDF, the NCCN guideline summaries for CLL and NHL, and patientfocused sheets from American Cancer Society. Many oncology clinics also provide printable cheatsheets that outline infusion times, premeds, and what to watch for at home.
Conclusion
Understanding Treanda dosage isn't just about numbers on a chartit's about feeling confident in the treatment plan, knowing when adjustments might be needed, and having a clear line of communication with your oncology team. Whether you're navigating the 100mg/m schedule for CLL or the 120mg/m plan for NHL, the key takeaways are: calculate your dose based on BSA, stay on top of lab checks, be ready for dose modifications if toxicities arise, and use the correct formulation to keep the medication stable.
If you or a loved one are embarking on a Treanda regimen, we'd love to hear your thoughts or answer any lingering questions. Share your experience in the comments, download the printable dosing table, and consider setting up a medicationreview appointment with your pharmacist or nurse practitioner. Together, we can make this journey a little less daunting and a lot more informed.
FAQs
What is the standard Treanda dose for chronic lymphocytic leukemia (CLL)?
The usual regimen for CLL is 100 mg/m² given intravenously on Days 1 and 2 of each 28‑day cycle, typically for up to six cycles.
How do I calculate my Treanda dose using body surface area (BSA)?
Measure your height (cm) and weight (kg), apply the Mosteller formula BSA = √(height × weight / 3600), then multiply the BSA by the prescribed mg/m² (100 for CLL, 120 for NHL) and round to the nearest milligram.
When will my oncologist reduce the Treanda dose?
Dose reductions are considered for significant toxicities—e.g., Grade 3/4 neutropenia or thrombocytopenia may lead to a step‑down (CLL: 100 → 50 → 25 mg/m²; NHL: 120 → 90 → 60 mg/m²). Non‑hematologic side‑effects like severe nausea or liver enzyme elevation can trigger similar reductions.
What are the two commercial formulations of Treanda and how are they prepared?
Treanda is available as a 90 mg/mL ready‑to‑use solution (45 mg/0.5 mL or 180 mg/2 mL vials) and as a lyophilized powder that is reconstituted to a 5 mg/mL solution. Both are diluted with 0.9% sodium chloride to a final infusion concentration of 0.2‑0.7 mg/mL before administration.
What safety monitoring is required before each Treanda infusion?
Before every cycle a complete blood count with differential, liver function tests, and renal panels are obtained. The infusion can proceed only if the absolute neutrophil count is ≥ 1 × 10⁹/L and platelets are ≥ 75 × 10⁹/L; otherwise the dose is held or reduced.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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