Acute lymphoblastic leukemia, infant - historical

The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the main pediatric B-ALL page for current regimens.

Last updated on 2024-07-23: 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

1. 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
2. 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 dosing details in supplement have been reviewed by our editors PubMed NCT00550992