Table 5.

Relapse ALL Regimen* (Adapted from VXLD Re-Induction)

Phase	Chemotherapy Agents	Schedule
Induction (28 days)	Dexamethasone PO	Days 1–14
	Vincristine IV	Days 1, 8, 15, 22
	Doxorubicin IV	Day 1
	Pegaspargase IM/IV	Days 2, 16
	Methotrexate IT	Day 1
	Cytarabine IT	Day 1
Consolidationa (28 days)	Dexamethasone PO	Days 1–5
	Vincristine IV	Day 3
	Methotrexate IV	Day 8
	Pegaspargase IM/IV	Day 9
	Cyclophosphamide IV	Days 15–19
	Etoposide IV	Days 15–19
	Methotrexate IT	Day 8
Consolidationb (56 days)	Mercaptopurine PO	Days 1–14 and 29–42
	Cyclophosphamide IV	Days 1, 29
	Cytarabine IV	Days 1–4, 8–11, 29–32, and 36–39
	Vincristine IV	Days 15, 22, 43, 50
	Pegaspargase IM/IV	Days 15, 43
	Methotrexate IT	Days 1, 8, 15, 22

Notes: *Regimen used as backbone for relapsed ALL after window with novel agents eg, Bortezomib, Carfilzomib, Pevonedistat, Daratumumab, Blinatumomab, and Nivolumab. ^{a, b} Depending on study protocol. ^bConsolidation based on modified BFM.

Abbreviations: VXLD, vincristine, dexamethasone, pegaspargase, doxorubicin; PO, oral; IV, intravenous; IM, intramuscular; IT, intrathecal.