The purpose of this study is increase the efficacy of consolidation (C1) after an intensification phase with high dose of methotrexate, applying analysis of minimal residual disease
REMISION INDUCTION Systemic chemotherapy: Prednisolone (PDN): * 60 mg/m2 day, i.v. or p.o., days 1 to 27 * 30 mg/m2 day, i.v. or p.o., days 28 to 35 Vincristine (VCR): 1,5 mg/m2 i.v., days 8, 15, 22 and 28. Daunorubicin (DNR): 30 mg/m2, i.v., days 8 and 15. L-asparaginase (L-ASA): 10.000 UI/m2, i.m. or i.v., days 9 to 11, 16 to 18 and 23 to 25. Cyclophosphamide (CFM): 1000 mg/m2, i.v., day 22. Intracranial chemotherapy Methotrexate (MTX), cytosine (ARA-C) and hydrocortisone, days 1 and 22 CONSOLIDATION TREATMENT (WEEKS 6 TO 14)with INTENSIFICACIÓN (C-1) * Mercaptopurine (MP) 50 mg/m2, p.o., days 1-7, 28-35 and 56-63 * MTX: 3g/m2, i.v., in 24 hours, days 1, 28 and 56. * VP-16: 150 mg/m2 i.v., days 14-15 and 42-43 * ARA-C: 1000 mg/m2 i.v., in 3 hours, days 14-15 and 42-43 * Intrathecal treatment, days 1, 28 and 56. REINDUCTION-CONSOLIDATION TREATMENT (R-C) (WEEKS 15 TO 23) Dexamethasone (DXM): * 6 mg/m2 day, p.o., days 1-21 * 3 mg/m2 day, p.o. or i.v., days 22-28 VCR: 1,5 mg/m2, i.v., days 1, 8 and 15 DNR: 30 mg/m2, i.v., days 1 and 8 L-ASA: 10.000 UI/m2 i.m. or i.v., days 8 and 9, 15 and 16, 22 and 23. CFM 1000 mg/m2 day, i.v., day 22 Mercaptopurine (MP) 50 mg/m2, p.o., days 35-42 MTX: 3g/m2, i.v., in 24 hours, day 35. VP-16: 150 mg/m2 i.v., days 49-50 ARA-C: 1.000 mg/m2 i.v., in 3 hours, days 49-50 Intrathecal treatment days 1 and 35. MAINTENANCE TREATMENT (M-1) Continuous treatment * MP 50 mg/m2/day, p.o. * MTX 20 mg/m2/week, i.m. Reinductions * VCR: 1,5 mg/m2 i.v., day 1. * PDN: 30 mg/m2/day, i.v. or p.o., days 1 to 7 * L-ASA: 20.000 UI/m2, i.m. or i.v., day 1. * Intrathecal treatment day 1 Five cycles, weeks 24, 30, 36, 42 and 48. During the week of administration cycle, continuous chemotherapy should be suspended. Intrathecal treatment: At the start of any reinduction cycle MAINTENANCE TREATMENT (M-2) (WEEKS 55-108) * MP 50 mg/m2/day, p.o. * MTX 20 mg/m2/week, i.m. * Intrathecal treatment, weeks 54 and 108 At the end of treatment should be done the study of MRD (flux cytometry)
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
150
60 mg/m2 day, i.v. or oral, dyas 1 to 27 30 mg/m2 day, i.v. or oral, days 28 to 35
1,5 mg/m2 i.v., days 8, 15, 22 and 28
30 mg/m2, i.v., days 8 and 15
Hospital General de Alicante
Alicante, Alicante, Spain
To evaluate the efficacy of treatment in order to response rate, relapse free survival and global survival
Time frame: 2 years
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10.000 UI/m2, i.m. or i.v., days 9 to 11, 16 to 18 and 23 to 25. Total: 9 doses.
1000 mg/m2, i.v., day 22.
Age \<1 year 1-2 years 2-3 years \> 3 years MTX 5 mg 8 mg 10 mg 12 mg
Edad \<1 year 1-2 years 2-3 years \> 3 years ARA-C 16 mg 16 mg 20 mg 30 mg
50 mg/m2,oral, days 1 to 7, 28-35 and 56-63
150 mg/m2 i.v., days 14-15 and 42-43
Hospital Valle Hebrón-Materno Infantil
Barcelona, Barcelona, Spain
Complejo Hospitalario Reina Sofía
Córdoba, Córdoba, Spain
Hospital Clínico San Carlos de Madrid
Madrid, Madrid, Spain
. Hospital Clínico Universitario Virgen de la Victoria
Málaga, Málaga, Spain
Hospital Joan XXIII
Tarragona, Tarragona, Spain
Hospital Clínic
Valencia, Valencia, Spain
Hospital La Fe
Valencia, Valencia, Spain
Hospital Universitario Dr. Peset
Valencia, Valencia, Spain
Hospital Clínico Lozano Blesa
Zaragoza, Zaragoza, Spain
...and 15 more locations