Treatment Scheme for 3 Stratification Treatment Groups According to DCLSG Protocol ALL-7
| Treatment Stratification . | Induction Protocol . | Consolidation Protocol . | Reinduction Protocol . | Maintenance Treatment . |
|---|---|---|---|---|
| SRG | I | M | no, till Oct.90 SRG II, from Oct.90 SRT | Maintenance treatment |
| RG* | I | M | II + CRT if initial CNS involvement* | Maintenance treatment versus maintenance + protocol S |
| EG* | I | E in CR Allogeneic BMT optional | II + CRT if initial CNS involvement* | Maintenance treatment |
| Months | 0 | 3 | 6 | 818 |
| Treatment Stratification . | Induction Protocol . | Consolidation Protocol . | Reinduction Protocol . | Maintenance Treatment . |
|---|---|---|---|---|
| SRG | I | M | no, till Oct.90 SRG II, from Oct.90 SRT | Maintenance treatment |
| RG* | I | M | II + CRT if initial CNS involvement* | Maintenance treatment versus maintenance + protocol S |
| EG* | I | E in CR Allogeneic BMT optional | II + CRT if initial CNS involvement* | Maintenance treatment |
| Months | 0 | 3 | 6 | 818 |
The chemotherapy applied in the protocols I, M, E, II, maintenance treatment, and protocol S are given in Appendix II. Treatment stratification was defined as follows: SRG: RF <0.8, without mediastinal mass, CNS involvement or EG characteristics; RG: as RF ≥0.8 and/or mediastinal mass and/or CNS involvement, without EG characteristics; and EG: independant of RF, immunophenotypically acute undifferentiated leukemia, and/or ≥1,000/μL blood blasts on day 8 after 7 days of monotherapy with prednisone (poor steroid response), and/or no remission after (the first part of) protocol I (day 42), and/or leukemic blasts karyotype t(9;22) or t(4;11).
Patients with initial CNS disease: 12 to 18 Gy of CRT in 15 days after protocol II.