SIOP PODC ALL regimen 21
| Induction (4 wk): prednisone prophase d1-7 |
| Prednisone (60 mg/m2) d1-29 |
| VCR (1.5 mg/m2) d8, 15, 22, 29 |
| l-ASPA (6000 IU/m2) 3×/wk (MWF) × 3 wk starting d8 |
| IT MTX d1, 8, 29 (extra d15, 22 if CNS 3) |
| Consolidation (4 wk) |
| VCR (1.5 mg/m2) d1 |
| 6-Mercaptopurine (75 mg/m2) d1-28 |
| IT MTX d1, 8, 15 |
| Interim maintenance (8 wk)* |
| Dexamethasone (6 mg/m2 per day) d1-5, 29-33 |
| VCR (1.5 mg/m2) d1-29 |
| Induction (4 wk): prednisone prophase d1-7 |
| Prednisone (60 mg/m2) d1-29 |
| VCR (1.5 mg/m2) d8, 15, 22, 29 |
| l-ASPA (6000 IU/m2) 3×/wk (MWF) × 3 wk starting d8 |
| IT MTX d1, 8, 29 (extra d15, 22 if CNS 3) |
| Consolidation (4 wk) |
| VCR (1.5 mg/m2) d1 |
| 6-Mercaptopurine (75 mg/m2) d1-28 |
| IT MTX d1, 8, 15 |
| Interim maintenance (8 wk)* |
| Dexamethasone (6 mg/m2 per day) d1-5, 29-33 |
| VCR (1.5 mg/m2) d1-29 |
| 6-Mercaptopurine (75 mg/m2) d1-50 |
| MTX (20 mg/m2) weekly d1, 8, 15, 22, 29, 36, 43, 50 |
| Delayed intensification (8 wk)* |
| Dexamethasone (10 mg/m2/day) d1-7, 15-21 |
| VCR (1.5 mg/m2) d1, 8, 15 |
| Doxorubicin (25 mg/m2) d1, 8, 15 |
| l-ASPA (6000 IU/m2) 3×/wk (MWF) × 2 wk starting d3 |
| Cyclophosphamide (1000 mg/m2) d29 |
| Cytarabine (75 mg/m2) d29-32, 36-39 |
| 6-Mercaptopurine (60 mg/m2) d29-43 |
| IT MTX d1, 29, 36 |
| Must have blood count recovery before starting d29 |
| Maintenance (84-d cycles until 30 mo from start of therapy) |
| Dexamethasone (6 mg/m2 per day) d1-5, 29-33, 57-61 |
| VCR (1.5 mg/m2) d1, 29, 57 |
| 6-Mercaptopurine (75 mg/m2) d1-84 |
| MTX (20 mg/m2) weekly starting d1 |
| IT MTX d 1, 29 for first 4 cycles, then d1 only |
| + Cranial RT for HR patients: 1260 cGy CNS1 and 2, 1800 cGy CNS3 |
| 6-Mercaptopurine (75 mg/m2) d1-50 |
| MTX (20 mg/m2) weekly d1, 8, 15, 22, 29, 36, 43, 50 |
| Delayed intensification (8 wk)* |
| Dexamethasone (10 mg/m2/day) d1-7, 15-21 |
| VCR (1.5 mg/m2) d1, 8, 15 |
| Doxorubicin (25 mg/m2) d1, 8, 15 |
| l-ASPA (6000 IU/m2) 3×/wk (MWF) × 2 wk starting d3 |
| Cyclophosphamide (1000 mg/m2) d29 |
| Cytarabine (75 mg/m2) d29-32, 36-39 |
| 6-Mercaptopurine (60 mg/m2) d29-43 |
| IT MTX d1, 29, 36 |
| Must have blood count recovery before starting d29 |
| Maintenance (84-d cycles until 30 mo from start of therapy) |
| Dexamethasone (6 mg/m2 per day) d1-5, 29-33, 57-61 |
| VCR (1.5 mg/m2) d1, 29, 57 |
| 6-Mercaptopurine (75 mg/m2) d1-84 |
| MTX (20 mg/m2) weekly starting d1 |
| IT MTX d 1, 29 for first 4 cycles, then d1 only |
| + Cranial RT for HR patients: 1260 cGy CNS1 and 2, 1800 cGy CNS3 |
Adapted from reference 1 with permission.
Addition from regimen 1.