Retrospective study of Dana Farber Consortium Protocol in newly diagnosed Egyptian adolescents and young adults with acute lymphoblastic leukemia: Tanta experience

Elashtokhy, Hossam Eldin A.; Elgohary, Heba E.; Eldeep, Basant B.; Gaber, Sally M.; Elbedewy, Tamer A.

doi:10.1186/s43046-021-00064-6

Journal of the Egyptian National Cancer Institute

Table 1 Dana Farber Consortium Protocol used in the study [11, 12]

From: Retrospective study of Dana Farber Consortium Protocol in newly diagnosed Egyptian adolescents and young adults with acute lymphoblastic leukemia: Tanta experience

Phase	Duration	Drug	Dose	Route of administration	Days	Notes
Phase I induction	4 weeks	Prednisone	40 mg/m²	Oral	D1-29
		Vincristine	1.4 mg/m²	Intravenous	D1,8,15,22	Maximum dose 2 mg
		Doxorubicin	30 mg/m²	Intravenous	D1,2
		Methotrexate	1.5 g/m²	Intravenous	D3	leucovorin rescue
		L-asparaginase	25,000 IU/m²	Intramuscular	D5	Ph-ve patients only
		Cytarabine	40 mg	Intrathecal	D1
		Methotrexate Cytarabine Hydrocortisone	12 mg 40 mg 15 mg	Intrathecal	D15,29
		Imatinib	600 mg		D3-15	Ph +ve patients only
Phase II induction and CNS therapy	3 weeks	Vincristine	1.4 mg/m²	Intravenous	D1	Maximum dose 2 mg
		Doxorubicin	30 mg/m²	Intravenous	D1
		6-Mercaptopurine	50 mg/m²	Oral	D1-14
		Methotrexate Cytarabine Hydrocortisone	12 mg 40 mg 15 mg	Intrathecal	D1, 4, 8, 11
		Cranial irradiation	1200 centigray		Over 8 days	With very high initial total leucocytic count or CNS infiltration unless patient will have BMT
Phase III Intensification therapy	10 cycles (cycle every 3 weeks)	Dexamethasone	9 mg/m² twice daily	Oral	D1-5
		6-Mercaptopurine	50 mg/m²	Oral	D1-14
		Vincristine	1.4 mg/m²	Intravenous	D1	Maximum dose 2 mg
		l-asparaginase	12,500 IU/m²	Intramuscular	D1, 8, 15
		Doxorubicin	30 mg/m²	Intravenous	D1	In the first 7 cycles
		Methotrexate	30 mg/m²	Intramuscular or oral	D2, 9, 16	In last 3 cycles
		Methotrexate Cytarabine Hydrocortisone	12 mg 40 mg 15 mg	Intrathecal	D1	6^th cycle only
Phase IV Continuation therapy	24 cycles (cycle every 3 weeks)	Dexamethasone	6 mg/m² twice daily	Oral	D1-5
		6-Mercaptopurine	50 mg/m²	Oral	D1-14
		Vincristine	1.4 mg/m²	Intravenous	D1	Maximum dose 2 mg
		Methotrexate	30 mg/m²	Intramuscular or oral	Weekly
		Methotrexate Cytarabine Hydrocortisone	12 mg 40 mg 15 mg	Intrathecal	Every 18 weeks at the start of the cycle

BMT bone marrow transplantation, CNS central nervous system, D day, Ph Philadelphia

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