Table 2.
Pediatric adopted BFM90 high risk.
| Prephase | |||
| Prednisolone | 60 mg/m2 | PO | (D1–7) |
| Induction | |||
| Prednisolone | 60 mg/m2 | PO | (D1–28) |
| Vincristine | 1.5 mg/m2 | IV | (D8, 15, 22, 29) |
| Epirubicin | 30 mg/m2 | IV | (D8, 15, 22, 29) |
| L-asparaginase | 10.000 u/m2 | IM | (D19, 22, 25, 28, 31, 34, 37, 40) |
| Triple age adjusted IT | IT | (D8, 15, 22, 29) | |
| High risk I (HRI) | |||
| Dexamethasone | 20 mg/m2 | PO | (D1–5) |
| Vincristine | 1.5 mg/m2 | IV | (D1–5) |
| 6-Mercaptopurine | 25 mg/m2 | PO | (D1–5) |
| MTX (6 HR infusion) | 3 g/m2 | IV | (D1) |
| L-asparaginase | 25.000 u/m2 | IM | (D6) |
| Triple age adjusted IT | IT | (D1) | |
| High risk II (HRII) | |||
| Dexamethasone | 20 mg/m2 | PO | (D1–5) |
| Vincristine | 1.5 mg/m2 | IV | (D1) |
| Ifosfamide | 400 mg/m2 | IV | (D1–5) |
| MTX (6 HR infusion) | 3 g/m2 | IV | (D1) |
| Epirubicin | 50 mg/m2 | IV | (D5) |
| L-asparaginase | 25.000 u/m2 | IM | (D6) |
| Triple age adjusted IT | IT | (D1) | |
| High risk III (HRIII) | |||
| Dexamethasone | 20 mg/m2 | PO | (D1–5) |
| Vincristine | 5 mg/m2 | IV | (D1) |
| Cytarabine | 1 g/m2/12 h | IV | (D2–5) |
| Etoposide | 150 mg/m2 | IV | (D2–5) |
| L-asparaginase | 25.000 u/m2 | IM | (D6) |
| Triple age adjusted IT | IT | (D1) | |
| Total number of HR are 9 cycles; then if the patient is in CR after the 9th, cranial prophylaxis (18 g) will be given | |||
| Maintenance maximum two years with pulses of | |||
| Vincristine | 1.5 mg/m2 | IV | (D1) |
| Prednisolone | 40 mg/m2 | PO | For 7 days every two months |
| 6-Mercaptopurine | 25 mg/m2 | PO | Daily |
| MTX | 20 mg/m2 | IM | Weekly |
| Triple intrathecal (Methotrexate, Ara-C, hydrocortisone) | IT | Every 2 months till the end of maintenance |
D: Day, HR: high risk, Gy: gray, MTX: Methotrexate, PO: per oral.