CCG 1953 therapy detail
Phase . | Treatment regimen . |
|---|---|
| Induction, 4 wk | |
| CPM | 250 mg/m2 every 12 h × 4 doses, days 2, 3 |
| DXM | 10 mg/m2 orally 3 times daily, days 0-20, no taper |
| VCR | 0.05 mg/kg, days 0, 14; 0.03 mg/kg day 7 |
| DNM | 2 mg/kg/dose intravenously over 30 min for patients age ≤ 90 d |
| 2 mg/kg/d; 4 mg/kg over 48 h, age > 90 d to < 6 mo | |
| 2.5 mg/kg/d; 5 mg/kg over 48 h, age 6 to < 9 mo | |
| 3 mg/kg/d; 6 mg/kg over 48 h, age ≥ 9 mo, as a 48-h continuous infusion through central venous catheter, days 0, 1 | |
| L-ASP | 6000 IU/m2 × 8 doses, 3 times weekly |
| ITT | Intrathecal triple therapy (methotrexate 7.5 mg; hydrocortisone 7.5 mg; ARA-C 15 mg), days 0, 7, 14, 21, 28 |
| MTX | 4 g/m2, days 21, 28 |
| CF rescue | 10 mg/m2 orally or intravenously every 6 h × ≥ 5 doses, start 18 h after MTX completion |
| VCR | 0.05 mg/kg intravenous push |
| Intensification, 4 wk | |
| VP-16 | 100 mg/m2, days 36-40 |
| DXM | 10 mg/m2 orally 3 times daily, days 0-20, no taper |
| CPM | 300 mg/m2/day intravenously, days 36-40 |
| Reinduction, 4 wk | |
| CPM | 250 mg/m2 every 12 h × 4 doses, days 2, 3 |
| VCR | 0.05 mg/kg days 0, 14; 0.03 mg/kg day 7 |
| DNM | 45 mg/m2/d × 2 days |
| DXM | 10 mg/m2 divided 3 times daily, days 0-20, no taper |
| L-ASP | 6000 IU/m2 intramuscularly × 8 doses, 3 times daily, days 0-20 |
| ITT | Days 0, 14 |
| BMT for 11q23/MLL | |
| Reintensification, 6 wk | |
| VCR | 0.75 mg/m2 intravenously, days 0, 7 |
| VHMTX | 6000 mg/m2 in 1 h, followed by 1200 mg/m2/h × 23 hours × 2 doses, days 0, 14 |
| CF rescue | 200 mg/m2 intravenously over 1 h, then 12 mg/m2 intravenous push every 3 h × 6 doses, then 12 mg/m2 intravenously or orally every 6 h until plasma MTX level < 0.1 μM; start 12 h following MTX completion (36 h after start) |
| VP-16 | 100 mg/m2/d intravenously, days 28-32 |
| CPM | 300 mg/m2/d intravenously over 30 min, days 28-32 |
| IT ARA-C | 15 mg intrathecally, days 7, 21 |
| Consolidation, 9 wk | |
| VHMTX | 6000 mg/m2 intravenously in 1 h, followed by 1200 mg/m2/h intravenously for 23 h, days 28, 42 |
| CF rescue | 10 mg/m2 orally or intravenously every 6 h × ≥ 5 doses, start 18 h after MTX completion |
| IT ARA-C | 15 mg intrathecally, days 35, 49 |
| VCR | 0.75 mg/m2 intravenously, days 28, 42 |
| IV ARA-C | 3000 mg/m2 intravenous 3 h infusion every 12 h, days 0, 2, 7, 8 for total of 8 doses |
| l-ASP | 6000 IU/m2 intramuscularly 3 h after intravenous ARA-C on days 1, 8 |
| Intensified maintenance, 72 d × 3 | |
| VCR | 0.75 mg/m2 intravenously, days 0, 28 |
| DXM | 10 mg/m2 divided orally 3 times daily, days 1-4 and 28-32 |
| 6-MP | 75 mg/m2 orally, days 0-48 |
| MTX | 20 mg/m2 intramuscularly every week, days 0, 7, 14, 21, 28, 35, 42 |
| VP-16 | 100 mg/m2/d, days 49-53 |
| CPM | 300 mg/m2/d intravenously over 30 min, days 49-53 |
| IT ARA-C | 15 mg intrathecally, days 0, 28 |
| Routine maintenance, 4 cycles, 1 y | |
| VCR | 1.5 mg/m2 intravenously every 4 wk × 12 doses, days 0, 28, 56 |
| PRED | 40 mg/m2 orally divided in 3 doses for 5 d with each VCR dose |
| MTX | 20 mg/m2 orally weekly, days 7, 14, 21, 28, 35, 42, 49, 56, 63, 70, 77 |
| 6-MP | 75 mg/m2 orally daily for 12 weeks per cycle |
| IT MTX | 8 mg age 12-23 mo, 10 mg age 24-35 mo, day 0 |
Phase . | Treatment regimen . |
|---|---|
| Induction, 4 wk | |
| CPM | 250 mg/m2 every 12 h × 4 doses, days 2, 3 |
| DXM | 10 mg/m2 orally 3 times daily, days 0-20, no taper |
| VCR | 0.05 mg/kg, days 0, 14; 0.03 mg/kg day 7 |
| DNM | 2 mg/kg/dose intravenously over 30 min for patients age ≤ 90 d |
| 2 mg/kg/d; 4 mg/kg over 48 h, age > 90 d to < 6 mo | |
| 2.5 mg/kg/d; 5 mg/kg over 48 h, age 6 to < 9 mo | |
| 3 mg/kg/d; 6 mg/kg over 48 h, age ≥ 9 mo, as a 48-h continuous infusion through central venous catheter, days 0, 1 | |
| L-ASP | 6000 IU/m2 × 8 doses, 3 times weekly |
| ITT | Intrathecal triple therapy (methotrexate 7.5 mg; hydrocortisone 7.5 mg; ARA-C 15 mg), days 0, 7, 14, 21, 28 |
| MTX | 4 g/m2, days 21, 28 |
| CF rescue | 10 mg/m2 orally or intravenously every 6 h × ≥ 5 doses, start 18 h after MTX completion |
| VCR | 0.05 mg/kg intravenous push |
| Intensification, 4 wk | |
| VP-16 | 100 mg/m2, days 36-40 |
| DXM | 10 mg/m2 orally 3 times daily, days 0-20, no taper |
| CPM | 300 mg/m2/day intravenously, days 36-40 |
| Reinduction, 4 wk | |
| CPM | 250 mg/m2 every 12 h × 4 doses, days 2, 3 |
| VCR | 0.05 mg/kg days 0, 14; 0.03 mg/kg day 7 |
| DNM | 45 mg/m2/d × 2 days |
| DXM | 10 mg/m2 divided 3 times daily, days 0-20, no taper |
| L-ASP | 6000 IU/m2 intramuscularly × 8 doses, 3 times daily, days 0-20 |
| ITT | Days 0, 14 |
| BMT for 11q23/MLL | |
| Reintensification, 6 wk | |
| VCR | 0.75 mg/m2 intravenously, days 0, 7 |
| VHMTX | 6000 mg/m2 in 1 h, followed by 1200 mg/m2/h × 23 hours × 2 doses, days 0, 14 |
| CF rescue | 200 mg/m2 intravenously over 1 h, then 12 mg/m2 intravenous push every 3 h × 6 doses, then 12 mg/m2 intravenously or orally every 6 h until plasma MTX level < 0.1 μM; start 12 h following MTX completion (36 h after start) |
| VP-16 | 100 mg/m2/d intravenously, days 28-32 |
| CPM | 300 mg/m2/d intravenously over 30 min, days 28-32 |
| IT ARA-C | 15 mg intrathecally, days 7, 21 |
| Consolidation, 9 wk | |
| VHMTX | 6000 mg/m2 intravenously in 1 h, followed by 1200 mg/m2/h intravenously for 23 h, days 28, 42 |
| CF rescue | 10 mg/m2 orally or intravenously every 6 h × ≥ 5 doses, start 18 h after MTX completion |
| IT ARA-C | 15 mg intrathecally, days 35, 49 |
| VCR | 0.75 mg/m2 intravenously, days 28, 42 |
| IV ARA-C | 3000 mg/m2 intravenous 3 h infusion every 12 h, days 0, 2, 7, 8 for total of 8 doses |
| l-ASP | 6000 IU/m2 intramuscularly 3 h after intravenous ARA-C on days 1, 8 |
| Intensified maintenance, 72 d × 3 | |
| VCR | 0.75 mg/m2 intravenously, days 0, 28 |
| DXM | 10 mg/m2 divided orally 3 times daily, days 1-4 and 28-32 |
| 6-MP | 75 mg/m2 orally, days 0-48 |
| MTX | 20 mg/m2 intramuscularly every week, days 0, 7, 14, 21, 28, 35, 42 |
| VP-16 | 100 mg/m2/d, days 49-53 |
| CPM | 300 mg/m2/d intravenously over 30 min, days 49-53 |
| IT ARA-C | 15 mg intrathecally, days 0, 28 |
| Routine maintenance, 4 cycles, 1 y | |
| VCR | 1.5 mg/m2 intravenously every 4 wk × 12 doses, days 0, 28, 56 |
| PRED | 40 mg/m2 orally divided in 3 doses for 5 d with each VCR dose |
| MTX | 20 mg/m2 orally weekly, days 7, 14, 21, 28, 35, 42, 49, 56, 63, 70, 77 |
| 6-MP | 75 mg/m2 orally daily for 12 weeks per cycle |
| IT MTX | 8 mg age 12-23 mo, 10 mg age 24-35 mo, day 0 |
CPM indicates cyclophosphamide; DXM, dexamethasone; VCR, vincristine; DNM, daunomycin; l-ASP, l-asparaginase; ITT, intrathecal triple therapy (methotrexate; hydrocortisone; ARA-C); BMT, bone marrow transplantation; ARA-C, cytosine arabinoside; MTX, methotrexate; CF, citrovorum factor (leucovorin); VP-16, etoposide; VHMTX, very high dose methotrexate; IT, intrathecal; IV, intravenous; 6-MP, mercaptopurine; and PRED, prednisone.