Protocols - Hemorio

CYTOREDUCTIVE PHASE:
Patients with initial leukometry > 50.000/mm 3 or major visceromegaly will receive a cytoreductive pretreatment:
TG VO 40 mg/m 2 /d
ARA-C IV/SC 40 mg/m 2 /d
If there is no leukometry appreciable reduction on D3, start induction.
Cytoreductive phase must not exceed 7 days.
1. INDUCTION
ARA-C IV 100mg/m 2 /Day D1-2 continuous infusion in 48 h
ARA-C IV 100mg/m 2 /dose 12/12 h D 3-8
IDARUBICIN IV 12 mg/m 2 in 4 hours D 3, 5,7
VP 16 IV 150 mg/m 2 in 1 hour D 6, 7,8
ARA-C IT Dose by age D1 and 8
ARA-C IT
AGE DOSE
< 1-year-old 20 mg
Between 1-2-years-old 26 mg
Between 2-3-years-old 34 mg
> = 3-years-old 40 mg
Notes:
VP 6 hours before ara-c
Idarubicin before ara-c.
Bone marrow on D15 of induction.
Blast on D15 QT continuation
5 % On D16 if there is no fever and no severe infection
2. SECOND INDUCTION:
HAM
HIGH RISK GROUP ONLY
Patients with good D15 response must have leukocytes count > 1000/mm 3 before the beginning of the
pack and good general conditions.
Patients with blasts on D15 receive the pack despite the leukocyte count, if the patient’s condition allows.
MO NO D1
HD ARA-C IV 3g/m 2 in 3 h 12/12 h D 1-3 (total of 6 doses)
MITOX. IV 10 mg/m 2 in 30 minutes D 3,4
ARA-C IT DOSE BY AGE D1
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