15 minutes on days 29 and 36, and asparaginase IM on days 29, 32, 36, and 39.
If bone marrow is M3 on day 29 or M2 on day 43, then patient is off study.
Patients then proceed to interim maintenance and delayed intensification on weeks 15-46. Courses repeat every 16 weeks.
Maintenance I and II (weeks 15-22 and 31-38): Patients receive:
Delayed Intensification (weeks 23-36 and 39-42): Patients receive:
Delayed Intensification-Reconsolidation (weeks 27-30 and 43-46): Patients receive:
Patients then proceed to continuation therapy on weeks 47-130. This consists of:
Patients with CNS 3 disease undergo whole brain radiotherapy (omit or discontinue mercaptopurine and IT methotrexate) on day 1. Testicular radiotherapy also begins on day 1.
Patients are followed every 2 months for 2 years, every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
A total of 260 patients will be accrued for this study within 3.1 years.with this clinical trial should be consulted before using this protocol.
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