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Treatment Name: C10403 Maintenance

C10403 Maintenance 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 maintenance 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, 29, and 57
  • Methotrexate 20 mg/m2 oral tablets by mouth once daily on Days 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78
    • Do not take methotrexate on Day 29 of the first four cycles of maintenance treatment
  • Dexamethasone 3 mg/m2 by mouth twice daily on Days 1, 2, 3, 4, and 5, then Days 29, 30, 31, and 32, and 33, then Days 57, 58, 59, 60, and 61
  • 6-Mercaptopurine 75 mg/m2 oral tablets by mouth once daily (at least one hour after evening meal) on Days 1 through 84
  • Methotrexate 15 mg intrathecal (I.T.) injection on Day 1 of every cycle of maintenance treatment and also on Day 29 of the first four cycles of maintenance treatment