Overview of asparaginase and glucocorticoid dosing, and sample collection for dexamethasone pharmacokinetics and anti–asparaginase antibody measurement. Patients received prednisone (PRED) at 40 mg/m2 per day during remission induction. Dexamethasone (DEX) was administered at 12 mg/m2 per day (SR/HR arm) and 8 mg/m2 per day (LR arm) in 5-day blocks during continuation weeks 1, 4, and 14; and at 8 mg/m2 on days 1 to 8 and 15 to 21 during reinduction I (weeks 7-9 of continuation) and reinduction II (weeks 17-19 of continuation) for both risk groups. Asparaginase (L-ASP) at 10 000 U/m2 per dose was administered to all patients during remission induction at days 6, 8, 10, 12, 14, and 16 (and at days 19, 21, and 23 for those with ≥ 1% residual leukemia cells in bone marrow on day 19). During the continuation phase, those in SR/HR arms received 25 000 U/m2 once per week from weeks 1 to 19; those in the LR arm received 10 000 U/m2 thrice weekly at weeks 7 to 9 and 17 to 19. Anti–asparaginase antibodies (ANTI–ASP) were determined on days 5, 19, and 34 of remission induction and day 1 of weeks 7 and 19 of continuation therapy, and dexamethasone pharmacokinetics (PK) were determined on day 1 of week 8 of continuation therapy.
