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Table 1 GD-2008-ALL protocol

From: Reduced intensity of early intensification does not increase the risk of relapse in children with standard risk acute lymphoblastic leukemia - a multi-centric clinical study of GD-2008-ALL protocol

treatment stages

SR group

IR group

HR group

Induction IA

Prednisone test

Prednisone test

Prednisone test

VDLD1

VDLD2

VDLD2

Induction Ib

CAM

CAM

CAM

14 days interval

14 days interval

CAM

CAM

Consolidation

mM

mM for B-ALL/M for T-ALL

(HR-1′,HR-2′,HR-3′)X2

Re-induction

VDLD3

VDLD3

VDLD4

CAM2

CAM2

CAM2

maintenance

A or B

A or B

A or B

  1. Note:
  2. Induction IA: Prednisone test and VDLD1/ VDLD2
  3. Induction IB: one CAM in SR group; two CAM in IR/HR groups
  4. Prednisone test: d1-d7: prednisone 60 mg/(m2·d), taken orally in three times (gradually increase from 15 mg/(m2·d) to the full dose according to clinical response. The cumulative dose should be more than 210 mg/m2 in 7 days. For patients with high tumor load, the initial dose can be reduced by 0.2–0.5 mg/(m2·d) to avoid tumor lysis syndrome)
  5. VDLD1: Dexamethasone (DEX, day 8 to 28, 6 mg/(m2·d), divided into three times; day 29 to 31, 3 mg/(m2·d); day 32–34 1.5 mg/(m2·d); day 35–37 0.75 mg/(m2·d). Vincristine (VCR): 1.5 mg/(m2·d) (≯ 2 mg/day), intravenous injection, d8, d15, d22, d29.Daunorubicin (DNR): 30 mg/(m2·d), intravenous, on day 8 and day 15.L-asp: 5000 U/(m2·d), intravenous infusion, day 12, day 15, day 18, day 24, day 27, day 30, day 33(8 times in total). Intrathecal therapy (IT): day 1, day 15,day 33
  6. VDLD2: extra two doses of DNR in VDLD1 30 mg/(m2·d), on day 22 and day 29
  7. CAM: cyclophosphamide (CTX): 1000 mg/(m2·d), PI>lh, day 1; 6-mercaptopurine (6-MP): 60 mg/(m2·d), day 1 to day 14; Cytarabine (Ara-c): 75 mg/(m2·d), intravenous infusion, day 3 to day 6, day 10 to day 13; IT: day 10
  8. mM: high-dose methotrexate (MTX), 2 g/(m2·d). 10% of the total dose is infused in the first 30 min, and the rest 90% of the total dose is infused continuously in the next 23.5 h on day 8, day 22, day 36 and day 50 of the consolidation therapy; 6-MP, 25 mg/(m2·d), orally, day 1 to day 56; IT: in the first 2 h after each intravenous infusion of MTX
  9. M: high-dose methotrexate (MTX), 5 g/(m2·d) (for T-ALL only), 10% of the total dose is infused in the first 30 min, and the rest 90% of the total dose is infused continuously in the next 23.5 h on day 8, day 22, day 36 and day 50 of the consolidation therapy; 6-MP, 25 mg/(m2·d), orally, day 1 to day 56; IT: in the first 2 h after each intravenous infusion of MTX
  10. VDLD3: DEX, day 1 to day 21, 8 mg/(m2·d), divided into three times; day 22 to 24, 4 mg/(m2·d); day 25–27 2 mg/(m2·d); day 28–30 1 mg/(m2·d). VCR: 1.5 mg/(m2·d) (≯ 2 mg/day), intravenous injection, d8, d15, d22, d29. Adriamycin (DOX): 30 mg/(m2·d), intravenous infusion, on day 8, day 15, day 22 and day 29.L-asp: 10000 U/(m2·d), intravenous infusion, day 8, day 11, day 15, day 18 (4 times in total). IT: day 1, day 15,day 33
  11. CAM2: CAM plus IT on day 3
  12. Maintenance A:6-MP:50 mg/m2 daily and MTX 20 mg/m2 once a week for continuous 74 weeks; IT: once in week 4, week 8, week 12 and week 16(T-ALL, extra IT in week 20 and week)
  13. Maintenance B: 6-MP:50 mg/m2 daily and MTX 20 mg/m2 once a week for continuous 7 weeks, followed with VCR:1.5 mg/m2, intravenous injection once and DEX 6 mg/m2 daily for 1 week. This eight-week protocol repeats for 9 times. 6-MP:50 mg/m2 daily and MTX 20 mg/m2 once a week for continuous 2 weeks; IT:the same to omaintenance A。
  14. HR-1′:DEX 20 mg/(m2·d), iv day 1 to day 5; VCR 1.5 mg/m2 iv d1, d6; MTX 5000 mg/m2, iv, PI:24 h, d1; CTX 200 mg/m2, iv,every 12 h for 5 times, day 2 to day 4; Ara-C 2000 mg/m2, iv, every 12 h for 2 times, day 5; L-ASP 25000 U/m2 iv, day 6 and day 11; IT d1
  15. HR-2′:DEX 20 mg/(m2·d), iv, day 1 to day 5; Vincristine (VDS) 3 mg/(m2·d) iv, day 1 and day 6; MTX 5000 mg/m2, iv, PI> 24 h, day 1; ifosfamide (IFO) 800 mg/m2 iv, PI> 1 h, every 12 h for 5 times, day 2 to day 4; L-ASP 25000 U/m2 iv, PI> 2 h, day 6 and day 11; DNR 30 mg/m2, iv, PI> 24 h, day 5; IT d1。
  16. HR-3′: DEX 20 mg/(m2·d), iv, day 1 to day 5; Ara-C 2000 mg/m2, iv, PI> 3 h, every 12 h for 4 times, day 1 to day 2; Etoposide 100 mg/m2 iv, PI> 1 h, every 12 h for 5 times, day 3 to day 5; L-ASP 25000 U/m2 iv, PI> 2 h, day 6, day 11; IT day 5。
  17. VDLD4: DEX 10 mg/(m2·d), divided into three oral doses, from day 1 to day 28; 5 mg/(m2·d) from day 29 to 31; 2.5 mg/(m2·d) from day 32–34; 1 mg/(m2·d) from day 35–37. VCR: 1.5 mg/(m2 · d) (≯ 2 mg/day), intravenous injection, day 8, day 15, day 22 and day 29. Adriamycin (DOX): 25 mg/(m2·d), intravenous infusion maintenance (PI)> 1 h, day 8, day 15, day 22, day 29; L-asp: 10000 U/(m2·d), PI> 1 h, day 8, day 11, day 15, day 18(4 times in total)
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BMC Cancer

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