TABLE 1.

Summary of modifications in this guideline as compared to the original NHL BFM 90 protocol

Treatment component	NHL BFM 90	This study
Methotrexate dose in blocks AA and BB	5 g/m2 in a 24-hour infusion	1–3 g/m2 in a 3-hour infusion
Leucovorin rescue	30 mg/m2 (hour 42 after the start of methotrexate) 15 mg/m2 (hours 48 and 54 after the start of methotrexate) Additional doses as per plasma methotrexate levels	15 mg/m2/dose starting at 24 hours after the start of methotrexate) No plasma methotrexate levels
Dose of ifosfamide in blocks A and AA	800 mg/m2/day on days 1 to 5	400 mg/m2/day on days 1 to 5
Proposed interval between chemotherapy blocks	14 days	21 days
Treatment of stage IV (CNS positive)	Intraventricular chemotherapy	Intrathecal chemotherapy
Treatment of patients with incomplete response after induction	Blocks CC, AA, and BB Second-look surgery if persistent mass	No block CC was given. Methotrexate dose was increased to 3 g/m2 in further blocks AA and BB No second-look surgery if persistent mass
Patient stratification	Stage, primary site location, and LDH levels	Stage
Second prephase in critical cases	No	Used for suspected or documented infections, unresolved renal and electrolyte disorders
Autologous stem cell rescue	For patients with persistent disease activity after CC block	Not available