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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main pediatric B-ALL page for current regimens.

1 regimens on this page 1 variants on this page

Induction

Cytarabine, Daunorubicin, L-Asparaginase, Vincristine, Dexamethasone

Regimen

Study	Dates of enrollment	Evidence
Pieters et al. 2007 (Interfant-99)	1999-2005	Non-randomized part of RCT
Pieters et al. 2019 (Interfant-06)	2006-02 to 2016-07	Non-randomized part of phase 3 RCT

Note: this regimen is listed as historic primarily due to the unavailability of L-asparaginase. Note that the timing takes into account the week-long pre-phase (i.e., induction starts on day 8).

Preceding treatment

Prednisone pre-phase

Chemotherapy

Cytarabine (Ara-C) 75 mg/m² IV over 30 minutes once per day on days 8 to 21
Daunorubicin (Cerubidine) 30 mg/m² IV over 60 minutes once per day on days 8 & 9
Asparaginase (Elspar) 5000 units/m² IV over 60 minutes once per day on days 15, 18, 22, 25, 29, 33
Vincristine (Oncovin) 1.5 mg/m² IV push once per day on days 8, 15, 22, 29

Glucocorticoid therapy

Dexamethasone (Decadron) 6 mg/m²/day PO or IV on days 8 to 29, then tapered off over days 30 to 36

28-day course

Subsequent treatment

Interfant-99: MARAM consolidation
Interfant-06: MARMA versus ADE consolidation

References

Interfant-99: Pieters R, Schrappe M, De Lorenzo P, Hann I, De Rossi G, Felice M, Hovi L, LeBlanc T, Szczepanski T, Ferster A, Janka G, Rubnitz J, Silverman L, Stary J, Campbell M, Li CK, Mann G, Suppiah R, Biondi A, Vora A, Valsecchi MG. A treatment protocol for infants younger than 1 year with acute lymphoblastic leukaemia (Interfant-99): an observational study and a multicentre randomised trial. Lancet. 2007 Jul 21;370(9583):240-250. link to original article PubMed NCT00015873
Interfant-06: Pieters R, De Lorenzo P, Ancliffe P, Aversa LA, Brethon B, Biondi A, Campbell M, Escherich G, Ferster A, Gardner RA, Kotecha RS, Lausen B, Li CK, Locatelli F, Attarbaschi A, Peters C, Rubnitz JE, Silverman LB, Stary J, Szczepanski T, Vora A, Schrappe M, Valsecchi MG. Outcome of Infants Younger Than 1 Year With Acute Lymphoblastic Leukemia Treated With the Interfant-06 Protocol: Results From an International Phase III Randomized Study. J Clin Oncol. 2019 Sep 1;37(25):2246-2256. Epub 2019 Jul 8. link to original article contains dosing details in supplement PubMed NCT00550992

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-''Note: this regimen is listed as historic primarily due to the unavailability of L-asparaginase.''
+''Note: this regimen is listed as historic primarily due to the unavailability of L-asparaginase. Note that the timing takes into account the week-long pre-phase (i.e., induction starts on day 8).''
 <div class="toccolours" style="background-color:#cbd5e8">
 ====Preceding treatment====
@@ Line 37: / Line 37: @@
 <div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Cytarabine (Ara-C)]]
+*[[Cytarabine (Ara-C)]] 75 mg/m<sup>2</sup> IV over 30 minutes once per day on days 8 to 21
-*[[Daunorubicin (Cerubidine)]]
+*[[Daunorubicin (Cerubidine)]] 30 mg/m<sup>2</sup> IV over 60 minutes once per day on days 8 & 9
-*[[Asparaginase (Elspar)]]
+*[[Asparaginase (Elspar)]] 5000 units/m<sup>2</sup> IV over 60 minutes once per day on days 15, 18, 22, 25, 29, 33
-*[[Vincristine (Oncovin)]]
+*[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> IV push once per day on days 8, 15, 22, 29
 ====Glucocorticoid therapy====
-*[[Dexamethasone (Decadron)]]
+*[[Dexamethasone (Decadron)]] 6 mg/m<sup>2</sup>/day PO or IV on days 8 to 29, then tapered off over days 30 to 36
+'''28-day course'''
 </div>
 <div class="toccolours" style="background-color:#cbd5e7">
@@ Line 51: / Line 52: @@
 ===References===
 # '''Interfant-99:''' Pieters R, Schrappe M, De Lorenzo P, Hann I, De Rossi G, Felice M, Hovi L, LeBlanc T, Szczepanski T, Ferster A, Janka G, Rubnitz J, Silverman L, Stary J, Campbell M, Li CK, Mann G, Suppiah R, Biondi A, Vora A, Valsecchi MG. A treatment protocol for infants younger than 1 year with acute lymphoblastic leukaemia (Interfant-99): an observational study and a multicentre randomised trial. Lancet. 2007 Jul 21;370(9583):240-250. [https://doi.org/10.1016/s0140-6736(07)61126-x link to original article] [https://pubmed.ncbi.nlm.nih.gov/17658395/ PubMed] [https://clinicaltrials.gov/study/NCT00015873 NCT00015873]
-# '''Interfant-06:''' Pieters R, De Lorenzo P, Ancliffe P, Aversa LA, Brethon B, Biondi A, Campbell M, Escherich G, Ferster A, Gardner RA, Kotecha RS, Lausen B, Li CK, Locatelli F, Attarbaschi A, Peters C, Rubnitz JE, Silverman LB, Stary J, Szczepanski T, Vora A, Schrappe M, Valsecchi MG. Outcome of Infants Younger Than 1 Year With Acute Lymphoblastic Leukemia Treated With the Interfant-06 Protocol: Results From an International Phase III Randomized Study. J Clin Oncol. 2019 Sep 1;37(25):2246-2256. Epub 2019 Jul 8. [https://doi.org/10.1200/jco.19.00261 link to original article] [https://pubmed.ncbi.nlm.nih.gov/31283407/ PubMed] [https://clinicaltrials.gov/study/NCT00550992 NCT00550992]
+# '''Interfant-06:''' Pieters R, De Lorenzo P, Ancliffe P, Aversa LA, Brethon B, Biondi A, Campbell M, Escherich G, Ferster A, Gardner RA, Kotecha RS, Lausen B, Li CK, Locatelli F, Attarbaschi A, Peters C, Rubnitz JE, Silverman LB, Stary J, Szczepanski T, Vora A, Schrappe M, Valsecchi MG. Outcome of Infants Younger Than 1 Year With Acute Lymphoblastic Leukemia Treated With the Interfant-06 Protocol: Results From an International Phase III Randomized Study. J Clin Oncol. 2019 Sep 1;37(25):2246-2256. Epub 2019 Jul 8. [https://doi.org/10.1200/jco.19.00261 link to original article] '''contains dosing details in supplement''' [https://pubmed.ncbi.nlm.nih.gov/31283407/ PubMed] [https://clinicaltrials.gov/study/NCT00550992 NCT00550992]
 [[Category:Acute lymphoblastic leukemia, infant regimens]]

Difference between revisions of "Acute lymphoblastic leukemia, infant - historical"