Table 14.9.
Week 1 | l-asparaginase | 10,000 IU/m2 SQ |
Cyclophospamide | 250 mg/m2 PO | |
Prednisone | 2 mg/kg PO daily for 7 days | |
Week 2 | l-asparaginase | 10,000 IU/m2 SQ |
CBC | ||
Week 3 | l-asparaginase | 10,000 IU/m2 SQ |
Cytosar | 300 mg/m2 SQ × 2 days | |
Week 4 | CBC | |
Week 5 | Cyclophospamide | 250 mg/m2 PO |
Week 7 | Methotrexate | 0.8 mg/kg IM |
Week 8 | CBC | |
Week 9 | Cyclophospamide | 250 mg/m2 PO |
Week 11 | Cytosar | 300 mg/m2 SQ × 2 days |
Chlorambucil | 1 tab/head PO or ½ tab daily for 2 days | |
Week 12 | CBC | |
Week 13 | Cyclophospamide | 250 mg/m2 PO |
Week 15 | Procarbazine | 50 mg/m2 PO daily for 14 days |
Week 16 | CBC | |
Week 17 | CBC | |
Week 18 | Cyclophospamide | 250 mg/m2 PO |
Week 20 | Cytosar | 300 mg/m2 SQ × 2 days |
Chlorambucil ×2 days |
1 tab/head PO or ½ tab daily for 2 days | |
Week 23 | Cyclophospamide | 250 mg/m2 PO |
Week 26 | Procarbazine | 50 mg/m2 PO daily for 14 days |
Week 27 | CBC, chem. | |
If not in remission, continue weeks 20–27 for three cycles |
PRED = Prednisone(non) – 2 mg/kg PO daily × 1 week then QOD.
L-ASP = l-asparaginase – (non) 10,000 IU/m2 SQ.
CTX = Cytoxan (mod) – 250 mg/m2 PO GIVE WITH 50 ml/kg of LRS once.
CYTOSAR = Cytosar (mod) – 300 mg/m2 SQ × 2 days (dilute 100 mg with 1 ml saline).
MTX = Methotrexate (mild) – 0.8 mg/kg IM.
LEUK = Leukeran (mild) – 1 tab/ferret PO (or ½ tablet daily for 2 days).
PCB = Procarbazine (mild) – 50 mg/m2 PO daily for 14 days.
Dose Reductions: if CBC indicates severe myelosuppression, reduce dosage by 25% for next treatment.
mod. = moderately myelo-suppressive; mild = mildly myelo-suppressive; non = nonmyelo-suppressive.
Mayer et al. (2014).