Treatment protocols
| Drug . | Dose . | Days of Administration . |
|---|---|---|
| Induction protocol I | ||
| Prednisone (orally) | 60 mg/m2 | 1-28, then taper over 3 × 3 days |
| Vincristine (iv) | 1.5 mg/m2 (max 2 mg) | 8, 15, 22, 29 |
| Daunorubicin (iv over 1 h) | 30 mg/m2 | 8, 15, 22, 29 |
| L-Asparaginase (iv over 1 h) | 10 000 IU/m2 | 12, 15, 18, 21, 24, 27, 30, 33 |
| Cyclophosphamide* (iv over 1 h) | 1000 mg/m2 | 36, 64 |
| Cytarabine (iv) | 75 mg/m2 | 38-41, 45-48, 52-55, 59-62 |
| 6-Mercaptopurine (orally) | 60 mg/m2 | 36-63 |
| Methotrexate (it)† | 12 mg† | 1, 15, 29, 45, 591-153 |
| Protocol M | ||
| 6-Mercaptopurine (orally) | 25 mg/m2 | 1-56 |
| Methotrexate‡ | 5 g/m2 | 8, 22, 36, 50 |
| Methotrexate (it)† | 12 mg† | 8, 22, 36, 50 |
| Reinduction protocol II | ||
| Dexamethasone (orally) | 10 mg/m2 | 1-21, then taper over 3 × 3 days |
| Vincristine (iv) | 1.5 mg/m2 (max 2 mg) | 8, 15, 22, 29 |
| Doxorubicin (iv over 1 h) | 30 mg/m2 | 8, 15, 22, 29 |
| L-Asparaginase (iv over 1 h) | 10 000 IU/m2 | 8, 11, 15, 18 |
| Cyclophosphamide* (iv over 1 h) | 1000 mg/m2 | 36 |
| Cytarabine (iv) | 75 mg/m2 | 38-41, 45-48 |
| 6-Thioguanine (orally) | 60 mg/m2 | 36-49 |
| Methotrexate (it)† | 12 mg† | 38, 45 |
| Drug . | Dose . | Days of Administration . |
|---|---|---|
| Induction protocol I | ||
| Prednisone (orally) | 60 mg/m2 | 1-28, then taper over 3 × 3 days |
| Vincristine (iv) | 1.5 mg/m2 (max 2 mg) | 8, 15, 22, 29 |
| Daunorubicin (iv over 1 h) | 30 mg/m2 | 8, 15, 22, 29 |
| L-Asparaginase (iv over 1 h) | 10 000 IU/m2 | 12, 15, 18, 21, 24, 27, 30, 33 |
| Cyclophosphamide* (iv over 1 h) | 1000 mg/m2 | 36, 64 |
| Cytarabine (iv) | 75 mg/m2 | 38-41, 45-48, 52-55, 59-62 |
| 6-Mercaptopurine (orally) | 60 mg/m2 | 36-63 |
| Methotrexate (it)† | 12 mg† | 1, 15, 29, 45, 591-153 |
| Protocol M | ||
| 6-Mercaptopurine (orally) | 25 mg/m2 | 1-56 |
| Methotrexate‡ | 5 g/m2 | 8, 22, 36, 50 |
| Methotrexate (it)† | 12 mg† | 8, 22, 36, 50 |
| Reinduction protocol II | ||
| Dexamethasone (orally) | 10 mg/m2 | 1-21, then taper over 3 × 3 days |
| Vincristine (iv) | 1.5 mg/m2 (max 2 mg) | 8, 15, 22, 29 |
| Doxorubicin (iv over 1 h) | 30 mg/m2 | 8, 15, 22, 29 |
| L-Asparaginase (iv over 1 h) | 10 000 IU/m2 | 8, 11, 15, 18 |
| Cyclophosphamide* (iv over 1 h) | 1000 mg/m2 | 36 |
| Cytarabine (iv) | 75 mg/m2 | 38-41, 45-48 |
| 6-Thioguanine (orally) | 60 mg/m2 | 36-49 |
| Methotrexate (it)† | 12 mg† | 38, 45 |
iv indicates intravenously; it, intrathecally.
With mesna.
Doses were adjusted for children under 3 years of age.
10% of the dose over 30 minutes and 90% as a 23.5-hour continuous iv infusion. Leucovorin rescue: 30 mg/m2 iv at hour 42; 15 mg/m2 iv at hour 48 and 54. Serum levels of MTX should be less than 3 μmol/L at hour 36 after the start of the MTX infusion, ≤1 μmol/L at hour 42, and ≤0.4 μmol/hour at hour 48.
Additional doses at days 8 and 22 for CNS-positive patients.