Pediatric leukemic unit

Alkwuit Hospital
Bwt …………. Kg
Protocol for High-risk B All Induction phase (35 days) Ht …………. Cm

BSA………….m2
Name …………………………………... Gender…………. Age ……... B.G …………….
Prednisone 1------------------------------------------28 day
30mg\m2\dose BD

Vincristine 1st 8th 15th 22nd

1.5mg\m2\dose
Iv push

Doxorubicin 1st 15th 22nd

25mg\m2\dose
Iv inf in Dex5%

l.Asparaginase 2nd 4th 9th 12th 16th 18th

6.ooounit\m2\dose
Iv inf over 3hours.
Or IM inj

Intrathecal 1st ® 8th 15th ⃰ 22nd ⃰ 29th

 Pediatric leukemic unit
Alkwuit Hospital

® Intrathecal on 1st day cytarabine with doses as follow:

Age (years) Dose
1- 1.99 30mg
2-2.99 50mg
≥3 70mg

It MTX doses as following:

Age (years) Dose
1-1.99 8mg
2-2.99 10mg
3-8.99 12mg
≥9 15mg

⃰ if CNS 3 patient
At day 29th BMA for morphology & MRD
 Pediatric leukemic unit
Alkwuit Hospital

Bwt ………….kg

Consolidation Phase(56days) Ht …………. Cm

Strat consolidation on day 36th (7days following day 29th LP) Or when peripheral BSA………….m2
counts recover with ANC≥750µl & Platelet ≥75,000/µl. B.G …………….
Name …………………………………... Gender…………. Age ……...

Cyclophosphamide 1st 29th ̑

1g \m2 \dose

6MP 1st -------------14th 29th -------------42nd

60mg\m2\dose

Cytarabine 1st ----4th 8th –11th 29th -32nd 36th –39ths

75mg\m2\dose
Iv or SC inj

Vincristine 15th 22nd 43rd 50th

1.5mg\m2\dose
Iv push over
1minut

L Asparaginase 15th 17th 19th 21st 23rd 25th 43rd 45th 47th 51st 53rd 55th
6000unit\m2\dose
Iv inf or IM inj

TIT 1st 8th 15th ⃰ 22nd ⃰

⃰ For CNS 3 patient only.

̑ Hold chemotherapy on day 29th until ANC≥750\µl &Plat≥75,000\µl.
 Pediatric leukemic unit
Alkwuit Hospital
Bwt ………….kg
Interim maintenance with HDMTX (63 days) Ht …………. Cm
Strat interim maintenance when peripheral counts recover with ANC≥750µl BSA………….m2
& Platelet ≥75,000/µl.
B.G …………….
Name …………………………………... Gender…………. Age ……...

Vincristine 1st 15th 29th 43rd

1.5mg\m2\dose

6mp 1st ---------------------------------------------------- 56th

25mg\m2\dose
orally

HD MTX 1st 15th 29th 43rd

3000-
3500mg\m2\dose
Iv inf

TIT 1st 29th

 Pediatric leukemic unit
Alkwuit Hospital
Bwt ………….kg

Ht …………. Cm
Delayed Intensification (56 days) BSA………….m2
To begin days 1 & 29 therapy patient should have ANC≥750µl & Platelet ≥75,000/µl. B.G …………….
Name …………………………………... Gender…………. Age ……...
Dexamethasone 1st ----------------7th 15th ------------21st

5mg\m2\dose

BD orally or iv

Vincristine 1st 8th 15th 43rd 50th

1.5mg\m2\dose

Iv push over 1 min

Doxorubicin 1st 15th

25mg\m2\dose

Iv inf

l. asparaginase 2nd 4th 6th 9th 11th 13th 16th 18th 20th 43rd 45th 47th

6000unit\m2\dose

Iv inf or im in

Cyclophosphamide 29th

1g\m2\dose

Iv inf

Cytarabine 29th ------32nd 36th --------39th

75mg\m2\dose

Iv or SC inj

6mp 29th ---------------42nd

60mg \m2\dose

Orally

TIT 1st 29th 36th

 Pediatric leukemic unit
Alkwuit Hospital
Bwt ………….kg
Maintenance phase Ht …………. Cm
To begin maintenance therapy patient should have ANC≥750µl &
BSA………….m2
Platelet ≥75,000/µl.
B.G …………….
Name …………………………………... Gender…………. Age ……...

weeks Date Drugs TWBC ANC Hb Plate

1. vincristine, prednisone,6mp,
IT
2. 6mp, MTX
3. 6mp, MTX
4. 6mp, MTX
5. vincristine, prednisone,6mp,
IT
6. 6mp, MTX
7. 6mp, MTX
8. 6mp, MTX
9. vincristine, prednisone,6mp
10. 6mp, MTX
11. 6mp, MTX
12. 6mp, MTX
13. vincristine, prednisone,6mp,
IT
14. 6mp, MTX
15. 6mp, MTX
16. 6mp, MTX
17. vincristine, prednisone,6mp,
IT
18. 6mp, MTX
19. 6mp, MTX
20. 6mp, MTX
21. vincristine, prednisone,6mp
 Pediatric leukemic unit
Alkwuit Hospital

22. 6mp, MTX

23. 6mp, MTX
24. 6mp, MTX
25. vincristine, prednisone,6mp,
IT
26. 6mp, MTX
27. 6mp, MTX
28. 6mp, MTX
29. vincristine, prednisone,6mp,
IT
30. 6mp, MTX
31. 6mp, MTX
32. 6mp, MTX
33. vincristine, prednisone,6mp
34. 6mp, MTX
35. 6mp, MTX
36. 6mp, MTX
37. vincristine, prednisone,6mp,
IT
38. 6mp, MTX
39. 6mp, MTX
40. 6mp, MTX
41. vincristine, prednisone,6mp,
IT
42. 6mp, MTX
43. 6mp, MTX
44. 6mp, MTX
45. vincristine, prednisone,6mp
46. 6mp, MTX
47. 6mp, MTX
 Pediatric leukemic unit
Alkwuit Hospital

48. 6mp, MTX

Repeat courses until 2years for female patient & 3 years for male patient from start of
Interim maintenance.
Pediatric leukemic unit
Alkwuit Hospital
Pediatric leukemic unit
Alkwuit Hospital
 Pediatric leukemic unit
Alkwuit Hospital

IT once every cycle after the first 4 cycles

Dose of chemotherapy:

Drugs Dose
Vincristine 1.5mg\m2\dose iv push over 1 min
Prednisone 20mg\m2\dose BD orally for 5days
6mp 75mg\m2\dose orally
MTX 20mg \m2\dose orally
It MTX doses as following:
Age (years) Dose
1-1.99 8mg
2-2.99 10mg
3-8.99 12mg
≥9 15mg