Pretransplant chemotherapy for patients with MLL+ ALL*
Regimen . | Dosing schedule . |
|---|---|
| Induction therapy | |
| VCR | 0.05 mg/kg, IV, days 1 and 8 |
| DEX | 10 mg/m2/d in 2 divided doses, IV, days 1-14 |
| CPA | 1200 mg/m2, DIV, day 2 |
| DXR | 25 mg/m2, IV or DIV, days 3 and 5 |
| VP-16 | 100 mg/m2, DIV, days 15-18 |
| Ara-C | 500 mg/m2, DIV, days 15-18 |
| TIT | Days 1 and 15 |
| Intensification therapy | |
| Phase A | |
| VP-16 | 100 mg/m2, DIV, days 1-3 |
| Ara-C | 200 mg/m2, DIV, days 4-8 |
| THP-DXR | 30 mg/m2, IV or DIV, days 4 and 5 |
| PSL | 60 mg/m2/d in 3 divided doses, PO, days 4-9 |
| ASP | 20 000 U/m2, DIV, day 9 |
| TIT | Day 1 |
| Phase B | |
| VCR | 0.05 mg/kg, IV, day 1 |
| DEX | 10 mg/m2/d in 2 divided doses, PO, days 1-7 |
| MTX | 3000 mg/m2/24 h, DIV, day 1 |
| Folinic acid | 15 mg/m2 (36 hours after the start of MTX, 7 times) |
| CPA | 600 mg/m2/d in 2 divided doses, DIV, days 2 and 3 |
| TIT | Day 1 |
| Phase C | |
| MIT | 10 mg/m2, IV or DIV, day 1 |
| VP-16 | 100 mg/m2, DIV, days 1-5 |
| Ara-C | 3000 mg/m2, DIV, days 1-5 |
| TIT | Day 1 |
Regimen . | Dosing schedule . |
|---|---|
| Induction therapy | |
| VCR | 0.05 mg/kg, IV, days 1 and 8 |
| DEX | 10 mg/m2/d in 2 divided doses, IV, days 1-14 |
| CPA | 1200 mg/m2, DIV, day 2 |
| DXR | 25 mg/m2, IV or DIV, days 3 and 5 |
| VP-16 | 100 mg/m2, DIV, days 15-18 |
| Ara-C | 500 mg/m2, DIV, days 15-18 |
| TIT | Days 1 and 15 |
| Intensification therapy | |
| Phase A | |
| VP-16 | 100 mg/m2, DIV, days 1-3 |
| Ara-C | 200 mg/m2, DIV, days 4-8 |
| THP-DXR | 30 mg/m2, IV or DIV, days 4 and 5 |
| PSL | 60 mg/m2/d in 3 divided doses, PO, days 4-9 |
| ASP | 20 000 U/m2, DIV, day 9 |
| TIT | Day 1 |
| Phase B | |
| VCR | 0.05 mg/kg, IV, day 1 |
| DEX | 10 mg/m2/d in 2 divided doses, PO, days 1-7 |
| MTX | 3000 mg/m2/24 h, DIV, day 1 |
| Folinic acid | 15 mg/m2 (36 hours after the start of MTX, 7 times) |
| CPA | 600 mg/m2/d in 2 divided doses, DIV, days 2 and 3 |
| TIT | Day 1 |
| Phase C | |
| MIT | 10 mg/m2, IV or DIV, day 1 |
| VP-16 | 100 mg/m2, DIV, days 1-5 |
| Ara-C | 3000 mg/m2, DIV, days 1-5 |
| TIT | Day 1 |
VCR, vincristine; DEX, dexamethasone; CPA, cyclophosphamide; DXR, doxorubicin; VP-16, etoposide; Ara-C, cytarabine; TIT, triple intrathecal therapy (age < 3 months: MTX, 3 mg; hydrocortisone, 10 mg; Ara-C, 6 mg; age ≥ 3 months: MTX, 6 mg; hydrocortisone, 10 mg; Ara-C, 12 mg); THP-DXR, tetrahydropyranyl doxorubicin; PSL, prednisolone; ASP, l-asparaginase; MTX, methotrexate; MIT, mitoxanthrone; IV, intravenously; DIV, drip intravenously; PO, by mouth.
The dose of each drug except VCR was reduced by one third in patients younger than 2 months and by one fourth in those 2 to 4 months of age.