Acute lymphoblastic leukemia, infant - historical
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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only.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
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