Table 1

Treatment therapy dose/schedule

Full-intensity therapy dose/scheduleReduced-intensity therapy dose/schedule
COP Cyclophosphamide 300 mg/m2 day 1 Same 
 Vincristine 1.0 mg/m2 day 1  
 Prednisone 60 mg/m2 (divided doses) days 1-7  
 IT MTX 8-15 mg/m2 day 1,3,5  
 IT hydrocortisone 8-15 mg/m2 days 1,3,5  
 IT cytarabine 15-30 mg/m2 days 1,3,5  
COPADM 1 Vincristine 2.0 mg/m2 day 1 (maximum: 2.0 mg) Same 
 Prednisone 60 mg/m2 (divided doses) days 1-5 then reduce over 3 d to 0  
 HDMTX 8000 mg/m2 day 1 in 4-h infusion + rescue  
 Cyclophosphamide 250 mg/m2 every 12 h days 2-4  
 Doxorubicin 60 mg/m2 day 2  
 IT MTX 8-15 mg/m2 days 1,3,5  
 IT hydrocortisone 8-15 mg/m2 days 2,4,6  
 IT cytarabine 15-30 mg/m2 days 2,4,6  
COPADM 2 Vincristine 2.0 mg/m2 d 1 (maximum: 2.0 mg) Same 
 Prednisone 60 mg/m2 (divided doses) d 1-5 then reduce over 3 d to 0  
 HDMTX 8000 mg/m2 d 1 in 4-h infusion + rescue  
 Cyclophosphamide 500 mg/m2 every 12 h d 2-4  
 Doxorubicin 60 mg/m2 day 2  
 IT MTX 8-15 mg/m2 days 1,3,5  
 IT hydrocortisone 8-15 mg/m2 days 2,4,6  
 IT cytarabine 15-30 mg/m2 days 2,4,6  
CYVE 1 and 2 Cytarabine 50 mg/m2 IV days 1-5 Deleted 
CNS− HD Ara-C 3000 mg/m2 days 2-5  
 Etoposide 200 mg/m2 days 2-5  
CYVE 1 and 2 Cytarabine 50 mg/m2 IV days 1-5 Deleted 
CNS+ HD Ara-C 3000 mg/m2 days 2-5  
 Etoposide 200 mg/m2 days 2-5  
 IT MTX and hydrocortisone 8-15 mg/m2 day 1  
 HDMTX 8000 mg/m2 day 18*  
 IT MTX, hydrocortisone, Ara-C (dose same as COPADM 1) day 19*  
Mini CYVE 1 and 2 Not applicable Cytarabine 50 mg/m2 IV days 1-5 
CNS−  Mini HD Ara-C 2000 mg/m2 days 2-5 
  Etoposide 100 mg/m2 days 2-5 
Mini CYVE 1 and 2 Not applicable Cytarabine 50 mg/m2 IV days 1-5 
CNS+  Mini HD Ara-C 2000 mg/m2 days 2-5 
  Etoposide 100 mg/m2 days 2-5 
  HDMTX 8000 mg/m2 day 18† in 4-h infusion + rescue 
  IT MTX, hydrocortisone, Ara-C (dose same as COPADM 1) day 19† 
M1 Vincristine 2.0 mg/m2 day 1 (maximum: 2.0 mg) Same 
 Prednisone 60 mg/m2 (divided doses) days 1-5 then reduce over 3 d to 0  
 Cyclophosphamide 500 mg/m2 every 12 h days 2,3  
 HDMTX 8000 mg/m2 day 1 in 4-h infusion + rescue  
 Doxorubicin 60 mg/m2 day 2  
 IT MTX 8-15 mg/m2 day 2  
 IT hydrocortisone 8-15 mg/m2 day 2  
 IT cytarabine 15-30 mg/m2 day 2  
M2 Cytarabine 50 mg/m2 sq every 12 h days 1-5 Deleted 
 Etoposide 150 mg/m2 days 1-3  
M3 Vincristine 2.0 mg/m2 day 1 (maximum: 2.0 mg) Deleted 
 Prednisone 60 mg/m2 (divided doses) days 1-5 then reduce over 3 d to 0  
 Cyclophosphamide mg/m2 days 1-2  
 Doxorubicin 60 mg/m2 day 1  
M4 Cytarabine 50 mg/m2 sq every 12 h days 1-5 Deleted 
 Etoposide 150 mg/m2 days 1-3  
Full-intensity therapy dose/scheduleReduced-intensity therapy dose/schedule
COP Cyclophosphamide 300 mg/m2 day 1 Same 
 Vincristine 1.0 mg/m2 day 1  
 Prednisone 60 mg/m2 (divided doses) days 1-7  
 IT MTX 8-15 mg/m2 day 1,3,5  
 IT hydrocortisone 8-15 mg/m2 days 1,3,5  
 IT cytarabine 15-30 mg/m2 days 1,3,5  
COPADM 1 Vincristine 2.0 mg/m2 day 1 (maximum: 2.0 mg) Same 
 Prednisone 60 mg/m2 (divided doses) days 1-5 then reduce over 3 d to 0  
 HDMTX 8000 mg/m2 day 1 in 4-h infusion + rescue  
 Cyclophosphamide 250 mg/m2 every 12 h days 2-4  
 Doxorubicin 60 mg/m2 day 2  
 IT MTX 8-15 mg/m2 days 1,3,5  
 IT hydrocortisone 8-15 mg/m2 days 2,4,6  
 IT cytarabine 15-30 mg/m2 days 2,4,6  
COPADM 2 Vincristine 2.0 mg/m2 d 1 (maximum: 2.0 mg) Same 
 Prednisone 60 mg/m2 (divided doses) d 1-5 then reduce over 3 d to 0  
 HDMTX 8000 mg/m2 d 1 in 4-h infusion + rescue  
 Cyclophosphamide 500 mg/m2 every 12 h d 2-4  
 Doxorubicin 60 mg/m2 day 2  
 IT MTX 8-15 mg/m2 days 1,3,5  
 IT hydrocortisone 8-15 mg/m2 days 2,4,6  
 IT cytarabine 15-30 mg/m2 days 2,4,6  
CYVE 1 and 2 Cytarabine 50 mg/m2 IV days 1-5 Deleted 
CNS− HD Ara-C 3000 mg/m2 days 2-5  
 Etoposide 200 mg/m2 days 2-5  
CYVE 1 and 2 Cytarabine 50 mg/m2 IV days 1-5 Deleted 
CNS+ HD Ara-C 3000 mg/m2 days 2-5  
 Etoposide 200 mg/m2 days 2-5  
 IT MTX and hydrocortisone 8-15 mg/m2 day 1  
 HDMTX 8000 mg/m2 day 18*  
 IT MTX, hydrocortisone, Ara-C (dose same as COPADM 1) day 19*  
Mini CYVE 1 and 2 Not applicable Cytarabine 50 mg/m2 IV days 1-5 
CNS−  Mini HD Ara-C 2000 mg/m2 days 2-5 
  Etoposide 100 mg/m2 days 2-5 
Mini CYVE 1 and 2 Not applicable Cytarabine 50 mg/m2 IV days 1-5 
CNS+  Mini HD Ara-C 2000 mg/m2 days 2-5 
  Etoposide 100 mg/m2 days 2-5 
  HDMTX 8000 mg/m2 day 18† in 4-h infusion + rescue 
  IT MTX, hydrocortisone, Ara-C (dose same as COPADM 1) day 19† 
M1 Vincristine 2.0 mg/m2 day 1 (maximum: 2.0 mg) Same 
 Prednisone 60 mg/m2 (divided doses) days 1-5 then reduce over 3 d to 0  
 Cyclophosphamide 500 mg/m2 every 12 h days 2,3  
 HDMTX 8000 mg/m2 day 1 in 4-h infusion + rescue  
 Doxorubicin 60 mg/m2 day 2  
 IT MTX 8-15 mg/m2 day 2  
 IT hydrocortisone 8-15 mg/m2 day 2  
 IT cytarabine 15-30 mg/m2 day 2  
M2 Cytarabine 50 mg/m2 sq every 12 h days 1-5 Deleted 
 Etoposide 150 mg/m2 days 1-3  
M3 Vincristine 2.0 mg/m2 day 1 (maximum: 2.0 mg) Deleted 
 Prednisone 60 mg/m2 (divided doses) days 1-5 then reduce over 3 d to 0  
 Cyclophosphamide mg/m2 days 1-2  
 Doxorubicin 60 mg/m2 day 1  
M4 Cytarabine 50 mg/m2 sq every 12 h days 1-5 Deleted 
 Etoposide 150 mg/m2 days 1-3  

IT doses are age adjusted below age 3 years. IV indicates intravenously; sq, subcutaneously.

*

Given after CYVE 1 only for CNS+ patients.

†

Given after mini CYVE 1 only for CNS+ patients.

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