Chemotherapy schedule for adult ALL according to the GOELAL02 trial
. | Route . | Dose . | Days . |
|---|---|---|---|
| Pretreatment, prednisolone | IV | 40 mg/m2 | -3 to -1 |
| Course I, induction | |||
| Prednisone/prednisolone | PO/IV | 40 mg/m2 | 1-21 |
| Vincristine | IV | 1.5 mg/m2 | 1, 8, 15, 22 |
| Idarubicin | IV | 5 mg/m2 | 1, 8, 15, 22 |
| L-asparaginase | IV | 7500 IU/m2 | 10, 13, 16, 19, 22, 25 |
| Methotrexate | IT | 10 mg/m2 | 3 |
| Methylprednisolone | IT | 40 mg | 3 |
| Course II, consolidation (day 35 after induction)* | |||
| Cyclophosphamide | IV | 650 mg/m2 | 1, 15, 29 |
| Cytarabine | IV | 75 mg/m2 | 3-6, 10-13, 17-20, 24-27 |
| 6-Mercaptopurine | PO | 60 mg/m2 | 1-29 |
| Methotrexate | IT | 10 mg/m2 | 3, 10, 17, 24, 31 |
| Methylprednisolone | IT | 40 mg | 3, 10, 17, 24, 31 |
| Course III (day 70 from induction)† | |||
| Methotrexate | IV 4 hours | 3000 mg/m2 | 1, 10 |
| Folinic acid | IV | 25 mg/m2/6 h | 2-4, 11-13 |
| Course IV, reinduction (day 90 after induction) | |||
| Dexamethasone | PO | 10 mg/m2 | 1-28 |
| Vincristine | IV | 1.5 mg/m2 | 1, 8, 15, 22 |
| Idarubicin | IV | 5 mg/m2 | 1, 8, 15, 22 |
| Cyclophosphamide | IV | 650 mg/m2 | 29 |
| Cytarabine | IV | 75 mg/m2 | 31-34, 38-41 |
| 6-Thioguanine | PO | 60 mg/m2 | 29-42 |
| Day 150, intensification conditioning before ABMT | |||
| Etoposide | IV 8 hours | 40 mg/kg | -6 |
| Cyclophosphamide | IV | 120 mg/kg | -5, -4 |
| Total body irradiation | Fractionated | 12 Gy | -3, -2, -1 |
| Randomized maintenance therapy for patients after ABMT | |||
| Interferon-α | SC | 3-4.5 MIU | 3/wk for 2 y |
. | Route . | Dose . | Days . |
|---|---|---|---|
| Pretreatment, prednisolone | IV | 40 mg/m2 | -3 to -1 |
| Course I, induction | |||
| Prednisone/prednisolone | PO/IV | 40 mg/m2 | 1-21 |
| Vincristine | IV | 1.5 mg/m2 | 1, 8, 15, 22 |
| Idarubicin | IV | 5 mg/m2 | 1, 8, 15, 22 |
| L-asparaginase | IV | 7500 IU/m2 | 10, 13, 16, 19, 22, 25 |
| Methotrexate | IT | 10 mg/m2 | 3 |
| Methylprednisolone | IT | 40 mg | 3 |
| Course II, consolidation (day 35 after induction)* | |||
| Cyclophosphamide | IV | 650 mg/m2 | 1, 15, 29 |
| Cytarabine | IV | 75 mg/m2 | 3-6, 10-13, 17-20, 24-27 |
| 6-Mercaptopurine | PO | 60 mg/m2 | 1-29 |
| Methotrexate | IT | 10 mg/m2 | 3, 10, 17, 24, 31 |
| Methylprednisolone | IT | 40 mg | 3, 10, 17, 24, 31 |
| Course III (day 70 from induction)† | |||
| Methotrexate | IV 4 hours | 3000 mg/m2 | 1, 10 |
| Folinic acid | IV | 25 mg/m2/6 h | 2-4, 11-13 |
| Course IV, reinduction (day 90 after induction) | |||
| Dexamethasone | PO | 10 mg/m2 | 1-28 |
| Vincristine | IV | 1.5 mg/m2 | 1, 8, 15, 22 |
| Idarubicin | IV | 5 mg/m2 | 1, 8, 15, 22 |
| Cyclophosphamide | IV | 650 mg/m2 | 29 |
| Cytarabine | IV | 75 mg/m2 | 31-34, 38-41 |
| 6-Thioguanine | PO | 60 mg/m2 | 29-42 |
| Day 150, intensification conditioning before ABMT | |||
| Etoposide | IV 8 hours | 40 mg/kg | -6 |
| Cyclophosphamide | IV | 120 mg/kg | -5, -4 |
| Total body irradiation | Fractionated | 12 Gy | -3, -2, -1 |
| Randomized maintenance therapy for patients after ABMT | |||
| Interferon-α | SC | 3-4.5 MIU | 3/wk for 2 y |
IV indicates intravenous injection; PO, per os; IT, intrathecal; MIU, million international units.
An additional course II was performed for patients in CR after this cycle.
On day 90, alloBMT was performed if there was an HLA-matched sibling donor. Unpurged BM collection was collected from patients older than 50 y or without an HLA-matched sibling donor.