THIS PROTOCOL IS FOR RESEARCH PURPOSES ONLY, SEE PAGE 1 FOR USAGE POLICY AALL0232

4.9.1b DELAYED INTENSIFICATION I (CONTINUED) ________________ _______________

All patients receive common Delayed Intensification I therapy. Delayed Intensification I Patient name or initials DOB
is 8 weeks (56 days). For patients with Down syndrome see Section 4.9.2.
,000/µL. See Section 4.9 for therapy interruption
guidelines. This Therapy Delivery Map is on two (2) pages.

DRUG ROUTE DOSAGE DAYS IMPORTANT NOTES OBSERVATIONS

VinCRIStine (VCR) IV push over 1.5 mg/m2/dose Days 1, 8, 15, 43 & 50 + Or infusion via minibag as a. Hx, phys, wgt
1 minute+ per institutional policy b. CBC (diff/plts)
Maximum dose: 2 mg c. CSF! Cell count,
Dexamethasone (DEX) PO 5 mg/m2/dose BID Days 1-7 & 15-21 10 mg/m2/day, divided BID. cytospin
(may give IV) See Section 4.9 for d. Bili, creatinine,
administration guidelines ALT
DOXOrubicin (DOXO) IV push 25 mg/m2/dose Days 1, 8 & 15 ! Obtain with each
PEG-asparaginase IM 2500 International Days 4 OR 5 OR 6 See Section 4.9 for IT administration
(PEG-ASP) (may give IV units/m2/dose AND Day 43 administration guidelines
over 1-2 hours OBTAIN OTHER
Cyclophosphamide IV over 30 min 2
1000 mg/m /dose Day 29 See Section 4.9 for STUDIES AS
REQUIRED FOR
(CPM) administration guidelines
GOOD PATIENT
Cytarabine (ARAC) IV or SubQ 75 mg/m2/dose Days 29-32 & 36-39 CARE
Thioguanine (TG) PO 60 mg/m2/dose Days 29-42 See Section 4.9 for
administration guidelines
Intrathecal Methotrexate IT Age (yrs) Dose Days 1, 29 & 36 See Section 4.9 for
(IT MTX) 1-1.99 8 mg administration guidelines
2-2.99 10 mg
3-8.99 12 mg Note age-based dosing
15 mg

Therapy Delivery Map Ht_________cm Wt________kg BSA________m2

Date Date Day VCR PEG-ASP IT MTX CPM ARAC TG Studies Comments
Due Given _____mg ______IU _____mg ____mg ____mg ____mg
Enter calculated dose above and actual dose administered below
29 ____mg ___mg ____mg ____mg b, c, d
30 ____mg ____mg
31 ____mg ____mg
32 ____mg ____mg
33 ____mg
34 ____mg
35 ____mg
36 ____mg ____mg ____mg b, c
37 ____mg ____mg
38 ____mg ____mg
39 ____mg ____mg
40 ____mg
41 ____mg
42 ____mg
43 _____mg _____IU b
---
50 _____mg
57 Begin next course (Interim Maintenance II, Section 4.10 if SER, CNS3,
testicular or steroid pre-treated (> 48 hours within week of diagnosis);
Maintenance, Section 4.12 if RER) on Day 57 or when blood count
parameters are met (whichever occurs later).

SEE PROTOCOL SECTION 5.0 FOR DOSE MODIFICATIONS. SEE SECTION 8.0 FOR SUPPORTIVE
CARE, and in particular Section 8.1 regarding evaluation of osteonecrosis (ON).

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