PROTOCOL FOR THE TREATMENT Acute Lymphoblastic Leukemia With Ph 'NEGATIVE IN ELDERLY PATIENTS (> 55 Years)
Prephase (days -5 to -1) Dexamethasone 10 mg/m2 bolus day IV for 5 days (-5 to -1).
Supplementary treatment: hydration minimum 2000 ml/day, allopurinol 300 mg / day, gastric
protection (as center), daily monitoring of blood glucose, daily monitoring of renal
function. Intrathecal treatment (diagnosis and prophylactic) day -5: 12 mg were administered
intrathecal methotrexate. The morphological study of the CSF will be defining initial CNS
involvement by LAL. Although it is recommended immunophenotypic study of CSF, the definition
of CNS involvement by LAL (and its therapeutic consequences) based on morphological
observation of blasts in CSF cytocentrifuge.
Remission induction:
Tolerance prephase period can be used to establish the final indication of treatment
(standard protocol or frail patients). Day 0 is free of treatment and is considered as +1
the first day of induction. The total duration of the induction is 30 days, consists of two
phases (Phase I, days +1 to +14 and phase II, days +15 to +30). Mandatory testing is
considered counting the percentage of blasts in peripheral blood +8 day of induction, a
myelogram to day +14 to assess early response and a day +35 to assess the complete remission
(days +1 to +14)
- Vincristine (VCR) 1 mg (absolute dose) IV 1 and 8.
- Idarubicin (IDA): 10 mg (absolute dose) IV 1, 2, 8 and 9.
- Dexamethasone (DEX): 10 mg/m2 bolus days 1 and 2 IV, 8 to 11
days +15 to +30)
- cyclophosphamide (CFM): 300 mg / m 2 iV in 1 hour 15 to 17. (3 total doses).
- Cytarabine (ARAC): 60 mg / m 2 iV in 1 hour 16 to 19, 23 to 26. (8 total doses).
- Vincristine (VCR) 1 mg (absolute dose) iV 1 and 8.
- Idarubicin (IDA): 10 mg (absolute dose) iV 1, 2, 8 and 9.
- Dexamethasone (DEX): 10 mg/m2 bolus days 1 and 2 iV, 8 to 11
Consolidation:
Cycles 1, 3, 5 MTX: 1,000 mg/m2, IV infusion of 24 hours day 1 L-ASA. 10,000 IU / m 2 IV or
IM Day 2 Cycles 2, 4, 6 ARAC: 1,000 mg/m2, IV in 3 hours on days 1, 3 and 5
Interventional
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Efficacy in terms of response rate
5 years
No
Spain: Ministry of Health
LAL-07OLD
NCT01366898
May 2010
December 2013
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