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Translating Guidelines and Clinical Trial Data to and ... - Amazon S3

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Induction TherapyTreatment OptionsPediatricNew YorkCOG/SRCOG/HR+T-cellAdultLinkerUKALL XIIAgentsVincristine, prednisone, daunomycin, asparaginase, CPMVincristine, DXM, prednisone, asparaginaseVincristine, DXM or prednisone, prednisone, asparaginase,daunomycinVincristine, DXM or prednisone, asparaginase, daunomycinVincristine, DXM or prednisone, asparaginase, daunomycinHyperCVADVincristine, i DXM, doxorubicin, i hyperfractionated t CPMCPM = cyclophosphamide; COG = Children’s Oncology Group; UKALL = Medical Research CouncilAcute Lymphoblastic Leukemia; HyperCVAD = hyperfractionated cyclophosphamide, vincristine,doxorubicin, <strong>and</strong> dexamethasone.National Cancer Institute. http://www.cancer.gov/cancer<strong>to</strong>pics/pdq/treatment/childALL/HealthProfessional/page4. Accessed January 14, 2013. NCCN <strong>Clinical</strong> Practice <strong>Guidelines</strong> in Oncology.http://www.nccn.org/professionals/physician_gls/pdf/all.pdf. Accessed January 4, 2013.Presymp<strong>to</strong>matic CNS Therapy(CNS Prophylaxis)• Effective systemic chemotherapy– HD MTX, DXM, asparaginase, thioguanine• Early intensification <strong>and</strong> optimization of intrathecaltherapy– Triple IT therapy vs IT MTX• Cranial irradiation– A central role in the 1960’s but employed less because ofserious long-term sequalaeHD = high dose; MTX = methotrexate; IT = intrathecal.Pui CH, et al. Semin Oncol. 2009;36(4 suppl 2):S2-S16.

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