Protocols - Hemorio

AGE MTX mg/m 2 ARA-C mg/m 2 DEXA mg/m 2
< 1 year old 6 16 1
Between 1-2 years old 8 20 1
Between 2-3 years old 10 26 2
> 3 years old 12 30 2
MTX/LCV: see notes / support measures of Protocol M
Block HR 2’ (HIGH RISK):
DEXA VO 20 mg/m 2 D1-5
VCR IV 1.5 mg/m 2 D1 E D6
HD-MTX IV 2 g/m 2 in 24 hours D1
LCV IV 15 mg/m 2 Hour 42, 48 and 54
DNR IV 30 mg/m 2 in 1 hour D5
IFOSFAMIDE IV 800 mg/m 2 every 12h D2-4 for 5 doses
Mesna IV 300 mg/m 2 4h and 8 h after ifosfamide
L-ASP IM 10000/m 2 D6
MTX / ARA-C / DEXA IT IT Dose by age D1
MTX/LCV: see notes / support measures of Protocol M
Note: vindesine (VDS) 3 mg/m 2 (max. 5mg), announced at the original Protocol, was substituted by VCR
because it was not, the first, available in Brazil.
Block HR 3’(HIGH RISK):
DEXA VO 20 mg/m 2 D1-5
HD-ARA-C IV 2 g/m 2 every 12h D1 -2
VP 16 IV 150 mg/m 2 infusion 1 hour every 12 h. Total of 5 doses D3-5
L-ASP IM 10000 IU /m 2 D6
MTX/ARA-C/DEXA IT Dose by age D5
Note: To LLA-T-bearing subjects, in the 1 st remission, with an allergic reaction to the L-ASP, ERWINASE
is indicated, at the same dose as L-ASP.
PROTOCOL II (all risk groups):
PHASE 1
DEXA VO 10 mg/m 2 / day in 3
doses
D1 – 22 (with a gradual decrease)
VCR IV 1.5 mg/m 2 D8, D15, D22, D29
DOX IV 30 mg/m 2 D8, D15, D22, D29
L-ASP IV/IM 10,000 IU / m 2 D8, D11, D15, D18
MTX IT dose by age D1 AND D 8 (if CNS + to the diagnosis)
PHASE 2
CPM IV infusion of 1 hour 1,000 mg/m 2 D36
ARA-C IV 75 mg/m 2 D38-41, D45 -48
TG 60 IV 60 mg/m 2 D36 to D49
MTX IT dose by age D 38 AND 45
PROPHYLACTIC RADIOTHERAPY OF CNS:
age dosage
< 1 year old No irradiation
≥ 1 year old 12 Gy
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