Postremission therapy for higher-risk ALL
Week . | Drug pair . |
|---|---|
| 1 | Etoposide 300 mg/m2 IV + cyclophosphamide 300 mg/m2 IV |
| 2 | Methotrexate 40 mg/m2 IV* + mercaptopurine 75 mg/m2 PO every evening |
| 3 | Methotrexate 40 mg/m2 IV* + cytarabine 300 mg/m2 IV |
| 4 | Vincristine 1.5 mg/m2 IV† + dexamethasone 8 mg/m2 PO per day in 3 divided doses |
| 5 | Etoposide 300 mg/m2 IV + cyclophosphamide 300 mg/m2 IV |
| 6 | Methotrexate 2000 mg/m2 IV* over 24 hours + mercaptopurine 75 mg/m2 PO every evening |
| 7 | Etoposide 300 mg/m2 IV + cytarabine 300 mg/m2 IV |
| 8 | Vincristine 1.5 mg/m2 IV† + dexamethasone 8 mg/m2 PO per day in 3 divided doses |
Week . | Drug pair . |
|---|---|
| 1 | Etoposide 300 mg/m2 IV + cyclophosphamide 300 mg/m2 IV |
| 2 | Methotrexate 40 mg/m2 IV* + mercaptopurine 75 mg/m2 PO every evening |
| 3 | Methotrexate 40 mg/m2 IV* + cytarabine 300 mg/m2 IV |
| 4 | Vincristine 1.5 mg/m2 IV† + dexamethasone 8 mg/m2 PO per day in 3 divided doses |
| 5 | Etoposide 300 mg/m2 IV + cyclophosphamide 300 mg/m2 IV |
| 6 | Methotrexate 2000 mg/m2 IV* over 24 hours + mercaptopurine 75 mg/m2 PO every evening |
| 7 | Etoposide 300 mg/m2 IV + cytarabine 300 mg/m2 IV |
| 8 | Vincristine 1.5 mg/m2 IV† + dexamethasone 8 mg/m2 PO per day in 3 divided doses |
Drug pairs were administered in weekly rotation, interrupted by reinduction therapy from weeks 16 to 21.
IV indicates intravenously; PO, orally.
Each high-dose methotrexate was followed by 5 doses of leucovorin 10 mg/m2 per dose administered every 6 hours at hours 44, 50, 56, 62, and 68 from the start of methotrexate infusion. In patients who received cranial irradiation (from weeks 55 to 57), methotrexate was given intramuscularly instead of intravenously after week 57.
The last high-dose methotrexate was given on week 53, after which it was replaced by regular-dose methotrexate.
Infants younger than 1 year received a dose of 0.05 mg/kg. The maximum dose was 2 mg.