CALGB 8811

Regimen

Course I: Induction (4 wks)

• Cyclophosphamide (Cytoxan) 1200 mg/m2 (800 mg/m2 if pts older than 60) iv d1
• Daunorubicine 45 mg/m2/d (30 mg/m2/d if pts older than 60) iv d1-3
• Vincristine 2 mg iv d1, 8, 15, 22
• Prednisone 60 mg/m2/d po d1-21 (d1-7 if pts older than 60)
• L-Asparaginase 6000 U/m2 sc d15, 18, 22, 25

Course II: Early intensification (4 wks/cycle x 2 cycles)

• Intrathecal methotraxate 15 mg d1
• Cyclophosphamide (Cytoxan) 1000 mg/m2 iv d1
• 6-Mercaptopurine (6-MP) 60 mg/m2/d po d1-14
• Cytarabine (Ara-C) 75 mg/m2/d sc d1-4, 8-11
• Vincristine 2 mg iv d15, 22
• L-Asparaginase 6000 IU/m2 sc d15, 18, 22, 25

Course III: CNS prophylaxis and interim maintenance (12 wks)

• Cranial radiation 2,400 cGy d1-12
• Intrathecal methotraxate 15 mg d1, 8, 15, 22, 29
• 6-Mercaptopurine (6-MP) 60 mg/m2/d po d1-70
• Methotraxate (MTX) 20 mg/m2 po d36, 43, 50, 57, 64

Course IV: Late intensification (8 wks)

• Doxorubicin 30 mg/m2 iv d1, 8, 15
• Vincristine 2 mg iv d1, 8, 15
• Dexamethasone (Decadron) 10 mg/m2/d po d1-14
• Cyclophosphamide (Cytoxan) 1000 mg/m2 iv d29
• 6-Thioguanine 60 mg/m2/d po d29-42
• Cytarabine (Ara-C) 75 mg/m2/d sc d29-32, 36-39

Course V: Prolonged maintenance (until 24 months from diagnosis)

• Vincristine 2 mg iv d1
• Prednisone 60 mg/m2/d po d1-5
• Methotraxate (MTX) 20 mg/m2 po d1, 8, 15, 22
• 6-Mercaptopurine (6-MP) 80 mg/m2/d po d1-28

Q4w

References

Larson R et al. A five-drug regimen remission induction regimen with intensive consolidation for adults with acute lymphoblastic leukemia: Cancer and Leukemia Group B Study 8811. Blood 1995; 85:2025