Phase and duration | Medication | Dosage Route and schedule |
---|---|---|
Induction 1A 29 days | 1. Pre-induction prednisolone | 60 mg/m2 PO day 1–7 |
2. Prednisolone | 40 g/m2 PO day 8–28 | |
3. Vincristine | 1.4Â mg/m2 IV day 8, 15, 22, 29 | |
4. Daunorubicin | 20Â mg/m2 IV day 8, 15, 29 | |
5. l-Asparaginase | 6000Â U/m2 SC day 8, 10, 12, 14, 16, 18, 20, 22, 24, 26 | |
6. CNS prophylaxis: *Triple prophylaxis | Â | |
   Methotrexate | 12 mg; IT day 8, 15, 22, 29 | |
   Cytarabine | 30 mg; IT day 8, 15, 22, 29 | |
   Hydrocortisone | 20 mg; IT day 8, 15, 22, 29 | |
Induction 2A 28Â days | Cyclophosphamide | 750Â mg/m2; IV day 1, 15 |
6-Mercaptopurine | 60 mg/m2 ; PO day 1–28 | |
Cytarabine | 75 mg/m2; IV day 1–4, 8–11, 15–18, 22–25 | |
CNS prophylaxis as Induction 1A | IT day 8, 15, 22, 29 | |
Induction 2B 56 days | Cyclophosphamide 6-Mercaptopurine | 750 mg/m2; IV day 1, 15 60 mg/m2; PO day 1–56 |
Methotrexate | Low risk: 20Â mg/m2; IV day 1, 11, 21, 31, 41 High risk: Start at 100Â mg/m2 and increase by 50Â mg/m2 up to 5 doses | |
CNS prophylaxis as in Induction 1A | IT day 8, 15, 22, 29 | |
Induction 1B 28Â days | Repeat Induction 1A | As in Induction 1A |
Consolidation 28 days | Cytarabine Vincristine Cyclophosphamide Daunorubicin 6-Mercaptopurine | 100 mg/m2; SC 12-hourly day 1–3, 15–17 1.4 mg/m2; IV day 1, 15 750 mg/m2; IV day 1 20 mg/m2; IV day 15 75 mg/m2; PO day 1–7, 15–21 |
CNS prophylaxis:-Â Drugs as in Induction 1A | IT day 1 | |
Maintenance 8 cycles for B-ALL (12 weeks per cycle) 96 weeks | Prednisolone Vincristine Daunorubicin l-Asparaginase 6-Mercaptopurine Methotrexate | 40 g/m2; PO day 1–7 1.4 mg/m2; IV day 1 20 mg/m2; IV day 1 6000 U/m2; SC day 1, 3, 5, 7 75 mg/m2; PO daily × 12 doses 15 mg/m2; PO weekly |
CNS prophylaxis:-Â Methotrexate | 12Â mg; IT day 1 of each cycle |