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Table 1 Modified MCP 841 Protocol

From: Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia with e1a3 BCR-ABL1 transcript in a Nigerian with sickle cell anemia: a case report

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

1.4 mg/m2 IV day 8, 15, 22, 29

4. Daunorubicin

20 mg/m2 IV day 8, 15, 29

5. l-Asparaginase

6000 U/m2 SC day 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

6. CNS prophylaxis: *Triple prophylaxis

 

   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

28 days

Cyclophosphamide

750 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: 20 mg/m2;

IV day 1, 11, 21, 31, 41

High risk: Start at 100 mg/m2 and increase by 50 mg/m2 up to 5 doses

CNS prophylaxis as in Induction 1A

IT day 8, 15, 22, 29

Induction 1B

28 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:- 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:- Methotrexate

12 mg; IT day 1 of each cycle