EAPLG

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Regimen

Age < 60 and WBC < 10,000/uL

Induction therapy

All trans retinoic acid (ATRA) 45 mg/m2 po qd in 2 divided doses d1 till hematologic CR
Cytarabine (Ara-C) 200 mg/m2/d civi d3-9
Daunorubicin 60 mg/m2/d iv d3-5

Consolidation therapy

cycle 1
Cytarabine (Ara-C) 200 mg/m2/d civi d1-7
Daunorubicin 60 mg/m2/d iv d1-3

cycle 2
Cytarabine (Ara-C) 1000 mg/m2 iv q12h x 8 doses
Daunorubicin 45 mg/m2/d iv d1-3

Maintenance therapy

ATRA 45 mg/m2 po qd in 2 divided doses d1-15 q3m x 2 year
6-Mercaptopurine (6-MP) 90 mg/m2 po qd x 2 year
Methotrexate (MTX) 15 mg/m2 po qw x 2 year

Age < 60 and WBC > 10,000/uL

Induction therapy

ATRA 45 mg/m2 po qd in 2 divided doses d1 till hematologic CR
Cytarabine (Ara-C) 200 mg/m2/d civi d3-9
Daunorubicin 60 mg/m2/d iv d3-5

Consolidation therapy

cycle 1
Cytarabine (Ara-C) 200 mg/m2/d civi d1-7
Daunorubicin 60 mg/m2/d iv d1-3
Intrathecal cytarabine 50 mg and methotrexate 15 mg x 3

cycle 2
Cytarabine (Ara-C) 2000 mg/m2 iv q12h x 10 doses
Daunorubicin 45 mg/m2/d iv d1-3
Intrathecal cytarabine 50 mg and methotrexate 15 mg x 2

Maintenance therapy

ATRA 45 mg/m2 po qd in 2 divided doses d1-15 q3m x 2 year
6-Mercaptopurine (6-MP) 90 mg/m2 po qd x 2 year
Methotrexate (MTX) 15 mg/m2 po qw x 2 year

Age > 60 and WBC < 10,000/uL

Induction therapy

ATRA 45 mg/m2 po qd in 2 divided doses d1 till hematologic CR
Daunorubicin 60 mg/m2/d iv d3-5

Consolidation therapy

cycle 1
Daunorubicin 60 mg/m2/d iv d1-3

cycle 2
Daunorubicin 45 mg/m2/d iv d1-3

Maintenance therapy

ATRA 45 mg/m2 po qd in 2 divided doses d1-15 q3m x 2 year
6-Mercaptopurine (6-MP) 90 mg/m2 po qd x 2 year
Methotrexate (MTX) 15 mg/m2 po qw x 2 year

Age > 60 and WBC > 10,000/uL

Induction therapy

ATRA 45 mg/m2 po qd in 2 divided doses d1 till hematologic CR
Cytarabine (Ara-C) 200 mg/m2/d civi d3-9
Daunorubicin 60 mg/m2/d iv d3-5

Consolidation therapy

cycle 1
Cytarabine (Ara-C) 200 mg/m2/d civi d1-7
Daunorubicin 60 mg/m2/d iv d1-3
Intrathecal cytarabine 50 mg and methotrexate 15 mg x 3

cycle 2
Cytarabine (Ara-C) 1000 mg/m2 iv q12h x 8 doses
Daunorubicin 45 mg/m2/d iv d1-3
Intrathecal cytarabine 50 mg and methotrexate 15 mg x2

Maintenance therapy

ATRA 45 mg/m2 po qd in 2 divided doses d1-15 q3m x 2 year
6-Mercaptopurine (6-MP) 90 mg/m2 po qd x 2 year
Methotrexate (MTX) 15 mg/m2 po qw x 2 year

References

Ades L et al. Is cytarabine useful in the treatment of acute promyelocytic leukemia? Results of a randomized trial from the European Acute Promyelocytic Leukemia Group. J Clin Oncol 2006; 24:5703