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Treatment Name: C10403 Delayed Intensification

C10403 Delayed Intensification is a Chemotherapy Regimen for Acute Lymphoid Leukemia (ALL)

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1) Curran E and Stock W. How I treat acute lymphoblastic leukemia in older adolescents and young adults. Blood. 2015;125:3702-3710.

2) Stock W, Luger SM, Advani AS, et al. A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: results of CALGB 10403. Blood. 2019 [Epub ahead of print].

Created: February 16, 2019 Updated: February 16, 2019

What is Acute Lymphoid Leukemia (ALL)?

Acute Lymphoid Leukemia (ALL), also known as acute lymphoblastic leukemia, is a disease of the lymphoid cells found in the bone marrow. Lymphoid cells are responsible for developing into cells of the immune system called B-cells, T-cells, or Natural Killer cells. In ALL, immature lymphoid cells know as "blasts" replicate at a very fast rate. Sometimes blasts crowd out the normal cells in the bone marrow so that red blood cells or platelets are unable to develop.

Common symptoms of ALL include fatigue, infection, and bruising or bleeding. ALL is the most common cancer diagnosed in children, but is rare in adults. Most cases of ALL are considered "de novo" meaning that the cause is unknown; however, some cases can be linked to certain genetic syndromes. There is no staging system for ALL. Chromosomes are often analyzed to determine which mutations in the chromosomes exist. The effectiveness of the treatment may depend upon the specific chromosome mutations that are present.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose your therapy.

Common C10403 delayed intensification starting doses

  • Vincristine 1.5 mg/m2 (maximum 2 mg) intravenous (I.V.) push or I.V. infusion over 10 to 15 minutes on Days 1, 8, 15, 43, and 50
  • Dexamethasone 5 mg/m2 by mouth on Days 1 through 7 and Days 15 through 21
  • Doxorubicin 25 mg/m2 I.V. push or I.V. infusion over 10 to 15 minutes on Days 1, 8, and 15
  • Pegaspargase 2500 units/m2 (maximum 3750 units) I.V. infusion over 1 to 2 hours or intramuscular (I.M.) injection on Days 4 and 43
  • Cyclophosphamide 1000 mg/m2 I.V. infusion over 30 to 60 minutes on Day 29
  • Cytarabine 75 mg/m2 I.V. infusion over 1 to 3 hours or subcutaneous (SubQ) injection on Days 29, 30, 31, 32 and Days 36, 37, 38, and 39
  • 6-Thioguanine 60 mg/m2 oral tablets by mouth once daily (at least one hour after evening meal)  on Days 29 through 42
  • Methotrexate 15 mg intrathecal (I.T.) injection on Days 1, 29, and 36