El Salvador, Guatemala, Honduras II treatment protocol: Induction, intensification, and consolidation.
| Induction | |
| Vincristine | 1.5 mg/m2 IV weekly x 4 |
| Prednisone | 40 mg/m2 PO daily x 28 |
| Asparaginase | 10,000 U/m2 IM days 2, 3, 5, 8, 10, 12 for all patients, plus days15, 17, 19 for patients with high-risk ALL |
| Daunomycin | 25 mg/m2 IV, day 1 for all patients; days 1, 8 for patients with high-risk ALL |
| Intensification | |
| Cyclophosphamide | 1 g/m2 IV day 22 |
| Cytarabine | 75 mg/m2 IV, days 23-26, 30-33 |
| 6-Mercaptopurine | 60 mg/m2 PO days 22-36 |
| Consolidation | |
| Methotrexate | 2 g/m2 (3 g/m2)** IV days 44 and 51 |
| 6-Mercaptopurine | 75 mg/m2 PO days 44-58 |
| Induction | |
| Vincristine | 1.5 mg/m2 IV weekly x 4 |
| Prednisone | 40 mg/m2 PO daily x 28 |
| Asparaginase | 10,000 U/m2 IM days 2, 3, 5, 8, 10, 12 for all patients, plus days15, 17, 19 for patients with high-risk ALL |
| Daunomycin | 25 mg/m2 IV, day 1 for all patients; days 1, 8 for patients with high-risk ALL |
| Intensification | |
| Cyclophosphamide | 1 g/m2 IV day 22 |
| Cytarabine | 75 mg/m2 IV, days 23-26, 30-33 |
| 6-Mercaptopurine | 60 mg/m2 PO days 22-36 |
| Consolidation | |
| Methotrexate | 2 g/m2 (3 g/m2)** IV days 44 and 51 |
| 6-Mercaptopurine | 75 mg/m2 PO days 44-58 |
| * Leucovorin, 15 mg/m2/dose q 6 hours x 8 doses, is begun 24 hours after the start of high-dose methotrexate. Additional doses of leucovorin are given if patients have evidence of methotrexate toxicity. | |||
| ** Patients at high risk only. | |||
| # Days 1, 15, 29 for all patients; days 8, 22 for patients with CNS disease. | |||
| Abbreviations: ALL, acute lymphocytic leukemia; IV, intravenous; IM, intramuscular; IT, intrathecal; CNS, central nervous system. | |||
| CNS-Directed Triple Intrathecal Therapy# | |||
| Triple IT therapy | Days 1, 15, 29 for all patients; add days 8, 22 for patients with CNS disease | ||
| Age < 1 yr | Age 1-3 yr | Age > 3 yr | |
| Methotrexate | 6 mg | 8 mg | 12 mg |
| Hydrocortisone | 12 mg | 16 mg | 24 mg |
| Cytarabine | 18 mg | 24 mg | 36 mg |
| * Leucovorin, 15 mg/m2/dose q 6 hours x 8 doses, is begun 24 hours after the start of high-dose methotrexate. Additional doses of leucovorin are given if patients have evidence of methotrexate toxicity. | |||
| ** Patients at high risk only. | |||
| # Days 1, 15, 29 for all patients; days 8, 22 for patients with CNS disease. | |||
| Abbreviations: ALL, acute lymphocytic leukemia; IV, intravenous; IM, intramuscular; IT, intrathecal; CNS, central nervous system. | |||
| CNS-Directed Triple Intrathecal Therapy# | |||
| Triple IT therapy | Days 1, 15, 29 for all patients; add days 8, 22 for patients with CNS disease | ||
| Age < 1 yr | Age 1-3 yr | Age > 3 yr | |
| Methotrexate | 6 mg | 8 mg | 12 mg |
| Hydrocortisone | 12 mg | 16 mg | 24 mg |
| Cytarabine | 18 mg | 24 mg | 36 mg |