Chemotherapy according to the GMALL protocols 06/99 and 07/03
Treatment phase . | Dose . | Route (duration) . | Time administered . |
|---|---|---|---|
| Prephase | |||
| Dexamethasone | 10 mg/m2 | By mouth | Days 1-5* |
| Cyclophosphamide | 200 mg/m2 | Intravenously | Days 3-5 |
| MTX | 15 mg | Intrathecally | Day 1† |
| Remission induction (INDI) | |||
| Dexamethasone | 10 mg/m2 | By mouth | Days 6-7, 13-16* |
| Vincristine | 2 mg | Intravenously | Days 6, 13, 20 |
| Daunorubicin | 45 mg/m2 | Intravenously | Days 6 + 7, 13 + 14 |
| PEG-asparaginase | 1000 U/m2 | Intravenously (2 h) | Day 20* |
| G-CSF | 5 μg/kg | Subcutaneously | Starting day 6 |
| Remission induction (INDII) | |||
| Cyclophosphamide | 1000 mg/m2 | Intravenously | Days 26, 46 |
| AraC | 75 mg/m2 | Intravenously | Days 28-31, 35-38, 42-45 |
| 6-MP | 60 mg/m2 | By mouth | Days 26-46 |
| MTX | 15 mg | Intrathecally | Days 28, 35, 42 |
| G-CSF | 5 μg/kg | Subcutaneously | Until ANC > 1 × 109/L |
| CNS-irradiation | 24 Gy | NA | 12 days, during INDII |
| Consolidation | |||
| Dexamethasone | 10 mg/m2 | By mouth | Days 1-5 |
| Vindesine | 3 mg/m2 | Intravenously | Day 1 |
| MTX | |||
| Age up to 55 y | 1.5 g/m2 | Intravenously (24 h) | Day 1 |
| Age more than 55 y | 1.0 g/m2 | Intravenously (24 h) | Day 1 |
| VP16 | 250 mg/m2 | Intravenously (1 h) | Days 4 + 5 |
| AraC | |||
| Age up to 55 y | 2 g/m2 × 2 | Intravenously (3 h) | Day 5 |
| Age more than 55 y | 1 g/m2 × 2 | Intravenously (3 h) | Day 5 |
| G-CSF | 5 μg/kg | Subcutaneously | Starting day 7 |
| MTX, AraC, DEX | 15 mg/40 mg/4 mg | Intrathecally | Day 12 |
Treatment phase . | Dose . | Route (duration) . | Time administered . |
|---|---|---|---|
| Prephase | |||
| Dexamethasone | 10 mg/m2 | By mouth | Days 1-5* |
| Cyclophosphamide | 200 mg/m2 | Intravenously | Days 3-5 |
| MTX | 15 mg | Intrathecally | Day 1† |
| Remission induction (INDI) | |||
| Dexamethasone | 10 mg/m2 | By mouth | Days 6-7, 13-16* |
| Vincristine | 2 mg | Intravenously | Days 6, 13, 20 |
| Daunorubicin | 45 mg/m2 | Intravenously | Days 6 + 7, 13 + 14 |
| PEG-asparaginase | 1000 U/m2 | Intravenously (2 h) | Day 20* |
| G-CSF | 5 μg/kg | Subcutaneously | Starting day 6 |
| Remission induction (INDII) | |||
| Cyclophosphamide | 1000 mg/m2 | Intravenously | Days 26, 46 |
| AraC | 75 mg/m2 | Intravenously | Days 28-31, 35-38, 42-45 |
| 6-MP | 60 mg/m2 | By mouth | Days 26-46 |
| MTX | 15 mg | Intrathecally | Days 28, 35, 42 |
| G-CSF | 5 μg/kg | Subcutaneously | Until ANC > 1 × 109/L |
| CNS-irradiation | 24 Gy | NA | 12 days, during INDII |
| Consolidation | |||
| Dexamethasone | 10 mg/m2 | By mouth | Days 1-5 |
| Vindesine | 3 mg/m2 | Intravenously | Day 1 |
| MTX | |||
| Age up to 55 y | 1.5 g/m2 | Intravenously (24 h) | Day 1 |
| Age more than 55 y | 1.0 g/m2 | Intravenously (24 h) | Day 1 |
| VP16 | 250 mg/m2 | Intravenously (1 h) | Days 4 + 5 |
| AraC | |||
| Age up to 55 y | 2 g/m2 × 2 | Intravenously (3 h) | Day 5 |
| Age more than 55 y | 1 g/m2 × 2 | Intravenously (3 h) | Day 5 |
| G-CSF | 5 μg/kg | Subcutaneously | Starting day 7 |
| MTX, AraC, DEX | 15 mg/40 mg/4 mg | Intrathecally | Day 12 |
Days of administration of remission induction counted from start of prephase.
MTX indicates methotrexate; VP16, etoposide; AraC, cytarabine; 6-MP, 6-mercaptopurine; NA, not appliable; DEX, dexamethasone
Slight variations in number of applications and total dose (DEX) and timing (PEG-Asp)
Delay in case of high PB blast count