BFM 2002 Working Sheets

SR-
PB day 8:<1000blasts/microL
and Age ≥1 yr and ≤6yr
and Initial WBC <20,000/microL
and M1 marrow on Day 33

Intermediate Risk (IR)

PB day 8:<1000blasts/microL
and Age ≥1 yr and > 6yr and/or Initial WBC ≥20,000/microL
and M1or M2 marrow on Day 15
and M1 marrow on Day 33
or
Standard risk criteria
but M3 marrow on Day 15
and M1 marrow on Day 33
Patient Name __Baby Sanvi _____________________ Weight 18.4kg____Kg Height: _____cm.
BSA:________m2
ID No. _____________
ALL-BFM 2002: Protocol I’A (for Precursor B ALL)
Fill in actual dose given for each drug. If a drug dose has been modified or delayed, indicate the drug, reason
(use the codes provided), date given and percentage of the planned dose in the corresponding spaces.
Date Day Delay Reason
Modification
______ 1 PRED_____ MTX___ _______________ ___________
______ 2 PRED_____ _______________ ___________
______ 3 PRED_____ _______________ ___________
______ 4 PRED_____ _______________ ___________
______ 5 PRED_____ _______________ ___________
______ 6 PRED_____ _______________ ___________
______ 7 PRED_____ _______________ ___________
______ 8 VCR____ PRED_____ DNR_____ _______________ ___________
______ 9 PRED_____ _______________ ___________
______ 10 PRED_____ _______________ ___________
______ 11 PRED_____ _______________ ___________
______ 12 PRED _____ L’ASP ______ MTX___ _______________ ___________
______ 13 PRED _____ _______________ ___________
______ 14 PRED _____ ______________ ___________
______ 15 VCR ____ PRED _____ L’ASP _______ DNR _____ _______________ ___________
______ 16 PRED _____ _______________ ___________
______ 17 PRED _____ _______________ ___________
______ 18 PRED _____ L’ASP _______ MTX___ _______________ ___________
(If CNS +ve)
______ 19 PRED _____ _______________ ___________
______ 20 PRED _____ _______________ ___________
______ 21 PRED _____ L’ASP ______ _______________ ___________
______ 22 VCR____ PRED _____ ______________ ___________
______ 23 PRED _____ ______________ ___________
______ 24 PRED _____ L’ASP ______ ______________ ___________
______ 25 PRED _____ ______________ ___________
______ 26 PRED _____ ______________ ___________
______ 27 PRED _____ L’ASP ______ MTX___ ______________ ___________
(If CNS +ve)
______ 28 PRED _____ ______________ ___________
______ 29 VCR____ PRED _____ ______________ ___________
(Start decreasing)
30 L’ASP ______ ______________ ____________
31 ______________
____________
32 ______________
____________
33 L’ASP ______ MTX___ ______________
____________
34 ______________
____________

PRED - Prednisolone 60mg/m2/d PO/IV in one to two divided doses per day with aH2 an
VCR - Vincristine 1.5 mg/m2/SD IV slow push in running NS (max. single dose 2mg)
DNR - Daunorubicin 30 mg/m2/d IV 1 hour Infusion (only 2 doses in Branch SR)
L-ASP(E.coli) - Asparaginase 5, 000 U/m2/d IV 1 hour Infusion
If Erwinia - 10,000 U/m2
MTX IT - Intrathecal Methotrexate (Dose age adapted)
< 1year 6mg
> 1 and < 2 years 8mg
> 2 and > 3 years 10mg
> 3 years 12mg
SD - Single Dose
PB for blast cells on Day 8...................................
Bone marrow to be done on Day 33 ….................

Patient Name _Master Mir Mohammed Shoaib Ali Weight 23.6____Kg Height: 115_cm.
BSA:_0.86__m2

ALL-BFM 2002: Protocol I’A (for SR -T, IR and HR ALL)

Fill in actual dose given for each drug. If a drug dose has been modified or delayed, indicate the drug, reason
(use the codes provided), date given and percentage of the planned dose in the corresponding spaces.
Date Day Delay Reason
Modification
______ 1 PRED_____ MTX___ _______________ ___________
______ 2 PRED_____ _______________ ___________
______ 3 PRED_____ _______________ ___________
______ 4 PRED_____ _______________ ___________
______ 5 PRED_____ _______________ ___________
______ 6 PRED_____ _______________ ___________
______ 7 PRED_____ _______________ ___________
______ 8 VCR____ PRED_____ DNR_____ _______________ ___________
______ 9 PRED_____ _______________ ___________
______ 10 PRED_____ ______________ ___________
______ 11 PRED_____ _______________ ___________
______ 12 PRED _____ L’ASP ______ MTX___ _______________ ___________
______ 13 PRED _____ ______________ ___________
______ 14 PRED _____ _______________ ___________
______ 15 VCR ____ PRED _____ L’ASP _____DNR _____ _______________ ___________
______ 16 PRED _____ _______________ ___________
______ 17 PRED _____ _______________ ___________
______ 18 PRED _____ L’ASP _______ MTX___ _______________ ___________
(If CNS +ve)
______ 19 PRED _____ _______________ ___________
______ 20 PRED _____ _______________ ___________
______ 21 PRED _____ L’ASP ______ _______________ ___________
______ 22 VCR____ PRED _____ DNR _____ ______________ ___________
______ 23 PRED _____ ______________ ___________
______ 24 PRED _____ L’ASP ______ ______________ ___________
______ 25 PRED _____ ______________ ___________
______ 26 PRED _____ ______________ ___________
______ 27 PRED _____ L’ASP ______ MTX___ ______________ ___________
(If CNS +ve)
______ 28 PRED _____ ______________ ___________
______ 29 VCR_____ PRED _____ DNR _____ ______________ ___________
(Start decreasing)
30 L’ASP ______ ______________ ____________
31 ______________ ____________
32 ______________ ____________
33 L’ASP ______ MTX___ ______________ _____________
Prednisolone 60mg/m2/d PO/IV in one to two divided doses per day with aH2 antagonist
VCR - Vincristine 1.5 mg/m2/SD IV slow push in running NS (max. single dose 2mg)
DNR - Daunorubicin 30 mg/m2/d IV 1 hour Infusion (only 2 doses in Branch SR)
L-ASP(E.coli) - Asparaginase 5, 000 U/m2/d IV 1 hour Infusion
If Erwinia - 10,000 U/m2
MTX IT - Intrathecal Methotrexate (Dose age adapted)
< 1year 6mg
> 1 and < 2 years 8mg
> 2 and > 3 years 10mg
> 3 years 12mg
SD - Single Dose
PB for blast cells on Day 8...................................
Bone marrow to be done on Day 33 ….................
Patient Name _BABY SAANVI , DOB- 25/11/2015, Weight 18.4KG___Kg Height: 109_cm. BSA:_0.74_m2

ALL-BFM 2002: Protocol IB (All pts.)

Requirements for beginning IB
 Good general status
 no severe infection
 creatinine within normal range for age
 Blood counts –

◦ WCC≥2000/microL
◦ granulocytes≥500/microL
◦ platelets≥50,000/microL
Fill in actual dose given for each drug. If a drug dose has been modified or delayed, indicate the drug, reason
(use the codes provided), date given and percentage of the planned dose in the corresponding spaces.
Date Day Delay Reason
Modification
______ 36 MP__25/50mg alternate___ CPM+MESNA____ _______________
___________
______ 37 MP_____ _______________ ___________
______ 38 MP_____ ARA-C_____ _______________ ___________
______ 39 MP_____ ARA-C_____ _______________ ___________
______ 40 MP_____ ARA-C_____ _______________ ___________
______ 41 MP_____ ARA-C_____ _______________ ___________
______ 42 MP_____ _______________ ___________
______ 43 MP_____ _______________ ___________
______ 44 MP_____ _______________ ___________
______ 45 MP_____ ARA-C_____ MTX IT___ _______________ ___________
______ 46 MP_____ ARA-C_____ _______________ ___________
______ 47 MP_____ ARA-C_____ _______________ ___________
______ 48 MP____ ARA-C_____ _______________ ___________
______ 49 MP_____ ______________ __________
______ 50 MP_____ _______________ ___________
______ 51 MP_____ _______________ __________
______ 52 MP_____ ARA-C_____ ______________ __________
______ 53 MP_____ ARA-C_____ ______________ ___________
______ 54 MP_____ ARA-C_____ ______________ __________
______ 55 MP_____ ARA-C_____ ______________ ___________
______ 56 MP_____ _____________ __________
______ 57 MP_____ _____________ __________
______ 58 MP_____ ______________ ___________
______ 59 MP_____ ARA-C_____ MTX IT___ ______________ __________
______ 60 MP_____ ARA-C_____ ______________ ___________
______ 61 MP_____ ARA-C_____ ______________ __________
______ 62 MP_____ ARA-C_____ ______________ ___________
63 MP_____ ______________ ____________
64 CPM+MESNA____ ______________ ____________

CPM - Cyclophosphamide 1000 mg/m2/d IV in 1 hour with pre(1hr) and post (4-6hr)hydration at double
maintainance fluids
 Diuresis and cystitis-prophylaxis 3000 ml/m2 IV in hour
 Mesna 400mg/m2 IV 0, 4, 8 hours after beginning CPM-infusion.
MP-6 Mercaptopurine-60 mg/m2/d PO ( round off to 50 mg tab and decrease the number of days, if necessary)
ARA-C -Cytarabine 75 mg/m2/d IV
MTX IT -Methotrexate (Dose age adapted)
< 1year 6mg
> 1 and < 2 years 8mg
> 2 and > 3 years 10mg
> 3 years 12mg
Patient Name Baby SAANVI _ Weight Kg Height: _____cm. BSA:_____m2 ID No. _____
ALL BFM 2002 Protocol M
Consolidation Therapy: SR, IR
Date Day Delay Reason
Modification
______ 1 MP_____ _______________ ___________
______ 2 MP_____ _______________ ___________
______ 3 MP_____ _______________ ___________
______ 4 MP_____ _______________ ___________
______ 5 MP_____ _______________ ___________
______ 6 MP_____ _______________ __________
______ 7 MP_____ _______________ __________
______ 8 MP_____ HD-MTX___ MTX-IT___ ______________ ___________
______ 9 MP_____ _______________ ___________
______ 10 MP_____ _______________ ___________
______ 11 MP_____ _______________ ___________
______ 12 MP_____ _______________ ___________
______ 13 MP_____ _______________ _________
______ 14 MP_____ _______________ ___________
______ 15 MP_____ _______________ ___________
______ 16 MP_____ _______________ ___________
______ 17 MP_____ _______________ ___________
______ 18 MP_____ _______________ ___________
______ 19 MP_____ _______________ ___________
______ 20 MP_____ _______________ ___________
______ 21 MP_____ _______________ ___________
______ 22 MP_____ HD-MTX___ MTX-IT___ ______________ ___________
______ 23 MP_____ ______________ ___________
______ 24 MP_____ _____________ ___________
______ 25 MP_____ ______________ ___________
______ 26 MP_____ ______________ ___________
______ 27 MP_____ ______________ ___________
______ 28 MP_____ ______________ ___________
______ 29 MP_____ ______________ ___________
30 MP_____ ______________ ___________
31 MP_____ ______________ ____________
32 MP_____ ______________ ____________
33 MP_____ _____________ ___________
34 MP_____ ______________ ____________
______ 35 MP_____ _______________ ___________
______ 36 MP_____ HD-MTX___ MTX-IT___ _______________ ___________
______ 37 MP_____ _______________ ___________
______ 38 MP_____ _______________ ___________
______ 39 MP_____ _______________ ___________
______ 40 MP_____ _______________ ___________
______ 41 MP_____ _______________ ___________
______ 42 MP_____ _______________ _____
____ 43 MP_____ _______________ ___________
______ 44 MP_____ _______________ ___________
______ 45 MP_____ _______________ ___________
______ 46 MP_____ _______________ ___________
______ 47 MP_____ _______________ ___________
______ 48 MP____ _______________ ___________
______ 49 MP_____ _______________ ___________
______ 50 MP_____ HD-MTX___ MTX-IT___ _______________ ___________
______ 51 MP_____ _______________ ___________
______ 52 MP_____ _______________ ___________
______ 53 MP_____ _______________ ___________
______ 54 MP_____ _______________ ___________
______ 55 MP_____ _______________ ___________
______ 56 MP_____ ______________ ___________

MP - 6-Mercaptopurine 25 mg/m2/d PO (in the evening on a fasting stomach without milk). Round off doses to 50
mg tabs . Do not break tablets.
Patient Name _BABY SAANVI_ Weight - Kg Height: _____cm. BSA:_____ m2 ID No._____

ALL BFM 2002 Protocol IIA

Re-induction Therapy : SR, MR, HR
Requirements for beginning Protocol II
 Continuous complete remission
 Satisfactory general status
 No severe infection
 Blood counts showing an ascending trend with
 WCC≥2500/microL
granulocytes≥1000/microL
platelets≥100,000/microL
In case of severe neuropathy, VCR may be deleted
If insufficient granulopoiesis( WBC <500/microL or granulocytes<200), doxorubicin/Vincristine can be postponed.
Fill in actual dose given for each drug. If a drug dose has been modified or delayed, indicate the drug, reason (use
the codes provided), date given and percentage of the planned dose in the corresponding spaces.
Date Day Delay Reason
Modification
______ 1 DEXA_____ MTX___ _______________ ___________
(If CNS +ve)
______ 2 DEXA_____ _______________ ___________
______ 3 DEXA_____ _______________ ___________
______ 4 DEXA_____ _______________ ___________
______ 5 DEXA_____ _______________ ___________
______ 6 DEXA_____ _______________ ___________
______ 7 DEXA_____ _______________ ___________
______ 8 VCR____ DEXA_____ L’ASP ______ DOX_____ _______________ ___________
______ 9 DEXA_____ _______________ ___________
______ 10 DEXA_____ _______________ ___________
______ 11 DEXA_____ L’ASP ______ _______________ ___________
______ 12 DEXA_____ _______________ ___________
______ 13 DEXA_____ _______________ ___________
______ 14 DEXA_____ _______________ ___________
______ 15 VCR ____ DEXA_____L’ASP _______ DOX _____ _______________ ___________
______ 16 DEXA_____ _______________ ___________
______ 17 DEXA_____ _______________ ___________
______ 18 DEXA_____L’ASP _______ MTX___ _______________ ___________
(If CNS +ve)
______ 19 DEXA_____ _______________ ___________
______ 20 DEXA_____ _______________ ___________
______ 21 DEXA_____ _______________ ___________
______ 22 VCR____ DEXA_____ DOX _____ ______________ ___________
(Start decreasing)
______ 23 DEXA_____ ______________ ___________
______ 24 DEXA_____ ______________ ___________
______ 25 DEXA_____ ______________ ___________
______ 26 DEXA_____ ______________ ___________
______ 27 DEXA_____ ______________ ___________
______ 28 DEXA_____ ______________ ___________
______ 29 VCR_____ DEXA_____ DOX _____ ______________ ___________
30 DEXA_____ ______________ ____________
31 DEXA_____ ______________ ____________
DEXA - Dexamethasone 10mg/m2/d PO/IV in 3 SD per day.
VCR - Vincristine 1.5 mg/m2/SD IV slow push in running NS (max. single dose 2mg)
DOX - Doxorubicin 30 mg/m2/d IV 1 hour Infusion
L-ASP(E.coli) - Asparaginase 10 000 U/m2/d IV 1 hour Infusion;If Erwinia-10,000 U/m2on Day
8,10,12,14,16,18,20 = 7doses
Peg L Asparginase 2000 to 2500unit/m2 two doses in a gap of 15 days
Patient Name BABY SSANVI _____ Weight Height: _____cm. BSA:_____m2 ID No.______

ALL BFM 2002 Protocol IIB

Reinduction Therapy : SR, MR, HR
Requirements for starting protocol IIB
 Satisfactory general condition
 No severe infection
 Creatinine within normal limits for age
 Blood counts showing an ascending trend with
◦ WCC≥2000/microL
◦ granulocytes≥500/microL
◦ platelets≥50,000/microL
Minimum requirements for an ARA-C block are
 WBC≥500/microL
 platelets≥30,000/microL
Fill in actual dose given for each drug. If a drug dose has been modified or delayed, indicate the drug, reason(use
the codes provided), date given and percentage of the planned dose in the corresponding spaces.
Date Day Delay Reason
Modification
______ 35 _______________ ___________
______ 36 TG_____ CPM+MESNA____ _______________ ___________
______ 37 TG_____ _______________ ___________
______ 38 TG_____ ARA-C_____ MTX IT____ _______________ ___________
______ 39 TG_____ ARA-C_____ _______________ ___________
______ 40 TG_____ ARA-C_____ _______________ ___________
______ 41 TG_____ ARA-C_____ _______________ ___________
______ 42 TG_____ _______________ ___________
______ 43 TG_____ _____________ ___________
______ 44 TG_____ _______________ ___________
______ 45 TG_____ ARA-C_____ MTX IT____ _______________ ___________
______ 46 TG_____ ARA-C_____ _______________ ___________
______ 47 TG_____ ARA-C_____ _______________ ___________
______ 48 TG_____ ARA-C_____ _______________ ___________
______ 49 TG_____ _______________
___________

CPM - Cyclophosphamide 1000 mg/m2/d IV in 1 hour

 Diuresis and cystitis-prophylaxis 3000 ml/m2IV in 24 hour
 Furosemide 0.5mg/kg IV 6 hour and 12 hour after CPM. Check fluid balance.
 Mesna (Uromitexan) 400mg/m2 IV 0, 4, 8 hours after beginning CPM-infusion.

TG -6 Thioguanine 60 mg/m2/d PO – to be taken on a fasting stomachin the evenings and NOT with milk.
Adjust the dose so that tablets are not broken and there is a cumulative dose of 840mg/m2 over 14 days.
ARA-C -Cytarabine 75 mg/m2/dIV

Pts start maintenance therapy 2 weeks after completion of this block of therapy.
Patient Name ___ Weight ____Kg Height: _____cm. BSA:_____m2 ID No ______
ALL BFM 2002 Block HR – 1’
Give G CSF after every HR block
Fill in actual dose given for each drug. If a drug dose has been modified or delayed, indicate the drug, reason
(use the codes provided), date given and percentage of the planned dose in the corresponding spaces.
Date Day Delay Reason
Modification
______ 1 DEXA___VCR____ TIT____ HD- MTX___ _______________ ___________
______ 2 DEXA___ CPM____ CPM____ _______________ ___________
______ 3 DEXA___ CPM____ CPM____ _______________ ___________
______ 4 DEXA___ CPM____ _______________ ___________
______ 5 DEXA___ HD-ARA-C____HD-ARA-C____ _______________ ___________
______ 6 VCR____ ASP____ _______________ ___________
______ 7 _______________ ___________
______ 8 _______________ ___________
______ 9 _______________ ___________
______ 10 _______________ ___________
______ 11 ASP____ _______________ ___________

DEXA - Dexamethasone 20mg/m2/d PO/IV in once daily doses for 5 days.

VCR - Vincristine 1.5 mg/m2/SD IV slow push in running NS (max. single dose 2mg)
 The first VCR-injection should be given one hour before the MTX-dose.
 The second dose of VCR should be delivered 12h prior to the hepatotoxic ASP.
HD-MTX IT - High Dose Methotrexate 5000 mg/m2/SD IV over 24 hour
 Urine-alkalization: urine pH>7.5 before, during and at least 48 hour after MTX infusion.
 1/10 of the total dose as loading dose PI in 30min.
 9/10 of the total dose as continuous infusion PI over 23 ½ hours.
 It is recommended that the MTX-infusion be started at 3p.m. The IT injection, (Triple drug), and the
sampling and measurement of MTX-levels at 24, 42, 48 hours then fall within the regular workday.
LCV - Leucovorin Rescue
LCV rescue for courses with normal MTX-levels : hour 42 after beginning MTX- inf : Leucovorin 15 mg/m 2 IV
Hour 48 after beginning of MTX-inf.: Leucovorin 15 mg/m2 IV
Hour 54 after beginning of MTX-inf.: Leucovorin 15 mg/m2 IV
CPM - Cyclophosphamide 200 mg/m /SD
2
IV 1 hour
 5 doses : q12h. Begin 7 hrs after the end of Mtx
 Liquids : 3000 ml/m2/d, check fluid balance
 Cystitis prophylaxis: Mesna (Uromitexan) 70mg/m2/SD 0, 4, 8 h after every CPM-
application
HD-ARA-C - Cytarabine 2000 mg/m2/SD IV 3 hour

2 doses 12 hour apart

Implementation of supportive therapy – to give steroid drops before the infusion and to continue for 2 days
after completion of the Ara C. High dose Vitamin B6 at 150mg/m2 IV/PO q 12 hrly for 3 days..

Caution : If nystagmus and/or ataxia occurs : discontinue infusion. If nystagmus/ataxia continues ,no
further HD-ARA-C infusion (Purkinje cell-degeneration).
ASP (E.coli) - Asparaginase 25000 U/m2/SD IV 2 hour

In the case of hypertenstivity alternative-preparations (1) Erwinia Asparaginase (SPEYWOOD): 25000
U/m2/SD and (@) PEG-, dose 1000 U/m2 (85U/kg if BSA<0.6m2). If this changes has already been tried no
further ASP therapy.
MTX/ARA-C/PRED IT (T.I.T) : Intrathecal methotrexate, cytarabine, prednisolone
Age MTX (IT) ARA-C IT PRED IT
< 1year 6mg 16mg 4mg
> 1 and < 2 years 8mg 20mg 6mg
> 2 and > 3 years 10mg 26mg 8mg
> 3 years 12mg 30mg 10mg

For the IT application of PRED, an aqueous solution is recommended e.g., Solu Decortin H 

The injection is carried out 2 hours after the start of the HD-MTX infusion (injections one after the other,
no “mixed shots”). If this is not possible, the IT injection should be applied no later than at the end of the MTX-
infusion.

Lowered-head position for at least 2 hours after intrathecal application.
Patient name : _SANGETHHA MASTHI____
ALL BFM 2002 Block HR – 2’
Fill in actual dose given for each drug. If a drug dose has been modified or delayed, indicate the drug, reason(use
the codes provided), date given and percentage of the planned dose in the corresponding spaces.
Date Day Delay Reason
Modification
______ 1 DEXA___Vinc____ TIT____ HD- MTX___ _______________
___________
______ 2 DEXA___ IFO____ IFO_____ _______________
___________
______ 3 DEXA___ IFO____ IFO_____ _______________
___________
______ 4 DEXA___ IFO____ _______________
___________
______ 5 DEXA___ DNR ____TIT( CNS+ pts only) _______________
___________
______ 6 Vinc____ ASP____ _______________
___________
______ 7 _______________
___________
______ 8 _______________
___________
______ 9 _______________
___________
______ 10 _______________
___________
______ 11 _______________
___________Asp

DEXA - Dexamethasone 20mg/m2/d PO/IV in single daily dose per day.

VDS -Vincristine 1.5 mg/m2/SD IV slow push in running NS (max. single dose 2mg)
 The first VCR-injection should be given one hour before the MTX-dose.
 The second dose of VCR should be delivered 12h prior to the hepatotoxic ASP.
 Since ASP retards the clearance of Vinc leading to prolonged exposure and hence enhanced risk of VDS-
induced neurotoxicity, it is prudent to administer ASP 12h after Vinc (on day 6)
HD-MTX IT - High Dose Methotrexate 5000 mg/m2/SD IV over 24 hour
 Urine-alkalization: urine pH>7.5 before, during and at least 48 hour after MTX infusion.
 1/10 of the total dose as loading dose PI in 30min.
 9/10 of the total dose as continuous infusion PI over 23 ½ hours.
 It is recommended that the MTX-infusion be started at 3p.m. The IT injection, (Triple drug), and the
sampling and measurement of MTX-levels at 24, 42, 48 hours then fall within the regular workday.
LCV - Leucovorin Rescue
LCV rescue for courses with normal MTX-levels : hour 42 after beginning MTX- inf :
Leucovorin 15 mg/m2 IV
Hour 48 after beginning of MTX-inf.: Leucovorin 15 mg/m2 IV
Hour 54 after beginning of MTX-inf.: Leucovorin 15 mg/m2 IV
2
IFO- Ifosfamide 800 mg/m / pro dosi IV 1 hour
 5 doses : q12h
 Liquids : 3000 ml/m2/d, check fluid balance
 Cystitis prophylaxis: Mesna (Uromitexan) 70mg/m2/SD 0, 4, 8 h after every CPM-
application
 ASP (E.coli) - Asparaginase 25000 U/m2/SD IV 2hour
 In the case of hypertenstivity,alternative-preparations (1) Erwinia Asparaginase
(SPEYWOOD): 25000 U/m2/SD and (@) PEG-, dose 500-2000 U/m2 (not yet defined). If this changes has already
been tried ,no further ASP therapy.
 MTX/ARA-C/PRED IT (T.I.T) : Intrathecal methotrexate, cytarabine, prednisolone
Age MTX (IT) ARA-C IT PRED IT
< 1year 6mg 16mg 4mg
> 1 and < 2 years 8mg 20mg 6mg
> 2 and > 3 years 10mg 26mg 8mg
> 3 years 12mg 30mg 10mg
Lowered-head position for at least 2 hours after intrathecal application
DNR : Daunorubicin 30 mg/m2 PI over 24 hour

Patient name : _SANGETHHA MASTHI_____eight ____Kg Height: _____cm. BSA:_____m2 ID No.

_____
ALL BFM 2002 Block HR – 3’
Fill in actual dose given for each drug. If a drug dose has been modified or delayed, indicate the drug, reason
(use the codes provided), date given and percentage of the planned dose in the corresponding spaces.
Date Day Delay Reason
Modification
______ 1 DEXA___ HD-ARA-C____ HD-ARA-C____ _______________ ___________
______ 2 DEXA___ HD-ARA-C____ HD-ARA-C____ _______________ ___________
______ 3 DEXA___ VP-16____ VP-16____ _______________ ___________
______ 4 DEXA___ VP-16____ VP-16____ _______________ ___________
______ 5 DEXA___ VP-16____ TIT____ _______________ ___________
______ 6 ASP____ _______________ ___________
______ 7 _______________ ___________
______ 8 _______________ ___________
______ 9 _______________ ___________
______ 10 _______________ ___________
______ 11 ASP____ _______________
___________

DEXA - Dexamethasone 20mg/m2/d PO/IV in single daily doses.

HD-ARA-C- Cytarabine 2000 mg/m2/SD IV 3 hour


4 doses 12 hour apart

Implementation of supportive therapy- Eye drops; Vit B6 150mg/m2 IV/PO 12 hrly for 3 days. Continue
double maintenance fluids for at least 6 days.

VP-16 - Etoposide 100mg/m2/d pro dosi PI over 1 hour


5 doses 12 hour apart

Monitoring of the patient during and for 5hour after the infusion

CAVE: fall in BP, arrhythmias, allergic reaction/anaphylaxis, bronchospasm, phlebitis/local
irritation

ASP (E.coli) - Asparaginase 25000 U/m2/SD IV 2hour


In the case of hypertenstivity alternative-preparations (1) Erwinia Asparaginase (SPEYWOOD): 25000
U/m2/SD and (@) PEG-, dose 500-2000 U/m2 (not yet defined). If this changes has already been tried no
further ASP therapy.

MTX/ARA-C/PRED IT (T.I.T) : Intrathecal methotrexate, cytarabine, prednisolone

Age MTX (IT) ARA-C IT PRED IT
< 1year 6mg 16mg 4mg
> 1 and < 2 years 8mg 20mg 6mg
> 2 and > 3 years 10mg 26mg 8mg
> 3 years 12mg 30mg 10mg
Patient Name BABY SAANVI Weight ____Kg Height: _____cm. BSA:_____m2 ID No.

Maintenance
Requirements for starting Maintenance
 Begin 2 weeeks after finishing Re-Induction
 Creatinine within normal limits for age
◦ ALT/AST,5xN for age
◦ Bilirubin <3xN for age+
 Blood counts showing an ascending trend with
◦ WCC≥1000/microL
◦ granulocytes≥200/microL
◦ platelets≥50,000/microL
◦ CBC and differential; LFTand RFT to be done monthly
Date Day Delay Reason
Modification
______ 1 MP_____ Vinc ____ Dexa _____ IT Mtx _____________ ___________
______ 2 MP_____ Dexa _______________ ___________
______ 3 MP_____ Dexa _______________ ___________
______ 4 MP_____ Dexa _______________ ___________
______ 5 MP_____ Dexa ______________ ___________
______ 6 MP_____ ______________ __________
______ 7 MP_____ MTX___ _______________ __________
______ 8 MP_____ ______________ ___________
______ 9 MP_____ ______________ ___________
______ 10 MP_____ _______________ ___________
______ 11 MP_____ _______________ ___________
______ 12 MP_____ _______________ ___________
______ 13 MP_____ _______________ _________
______ 14 MP_____ MTX___ ______________ ___________
______ 15 MP_____ _______________ ___________
______ 16 MP_____ _______________ ___________
______ 17 MP_____ _______________ ___________
______ 18 MP_____ _______________ ___________
______ 19 MP_____ _____________ ___________
______ 20 MP_____ _______________ ___________
______ 21 MP_____ MTX___ _______________ ___________
______ 22 MP_____ ________ ___________
______ 23 MP_____ ______________ ___________
______ 24 MP_____ _____________ ___________
______ 25 MP_____ ______________ ___________
______ 26 MP_____ ______________ ___________
______ 27 MP_____ ______________ ___________
______ 28 MP_____ MTX___ ______________ ___________
______ 29 MP_____ VInc Dexa ______________ ___________
30 MP_____ Dexa ______________ ___________
31 MP_____ Dexa ______________ ____________
32 MP_____ Dexa ______________ ____________
33 MP_____ Dexa _____________ ___________
34 MP_____ ______________ ____________
______ 35 MP_____ MTX___ _______________ ___________
______ 36 MP_____ _______________ ___________
______ 37 MP_____ _______________ ___________
______ 38 MP_____ _______________ ___________
______ 39 MP_____ _______________ ___________
______ 40 MP_____ _______________ ___________
______ 41 MP_____ _______________ ___________
______ 42 MP_____ MTX___ _______________ ___________
______ 43 MP_____ _______________ ___________
______ 44 MP_____ _______________ ___________
______ 45 MP_____ _______________ ___________
______ 46 MP_____ _______________ ___________
______ 47 MP_____ _______________ ___________
______ 48 MP____ _______________ ___________
______ 49 MP_____ MTX___ _______________ ___________
______ 50 MP_____ _______________ ___________
______ 51 MP_____ _______________ ___________
______ 52 MP_____ _______________ ___________
______ 53 MP_____ _______________ ___________
______ 54 MP_____ _______________ ___________
______ 55 MP_____ _______________ ___________
______ 56 MP_____ MTX___ ______________ ___________
________57 MP______ Vinc Dexa _______________ _________
________58 MP______ Dexa ______________ __________
________59 MP______ Dexa ______________ ___________
________60 MP ______ Dexa _______________ ____________
_______ 61 MP ______ Dexa ______________ __________
_______ 62 MP_______ _______________ __________
______ 63 MP_____ MTX___ _______________ ___________
______ 64 MP_____ _______________ ___________
______ 65 MP_____ _______________ ___________
______ 66 MP_____ _______________ ___________
______ 67 MP_____ _______________ ___________
______ 68 MP____ _______________ ___________
______ 69 MP_____ MTX___ _______________ ___________
______ 70 MP_____ _______________ ___________
_______71 MP_____ _____________ ___________
______ 72 MP_____ _______________ ___________
______ 73 MP_____ _______________ ___________
______ 7 4 MP_____ _______________ ___________
______ 75 MP_____ ______________ ___________
______ 76 MP_____ ______________ __________
______ 77 MP_____ MTX___ _______________ __________
______ 78 MP_____ ______________ ___________
______ 79 MP_____ ______________ ___________
______ 80 MP_____ _______________ ___________
______ 81 MP_____ _______________ ___________
______ 82 MP_____ _______________ ___________
______ 83 MP_____ _______________ _________
______ 84 MP_____

MP - 6-Mercaptopurine 50 mg/m2/d PO (in the evening on a fasting stomach without milk). Round off doses to 50
mg tabs . Do not break tablets.
MTX- 20mg/m2/day once a week. Do not give Septran on the same day
Dexamethasone 6 mg/m2/day for 5 days
Vincristine 1.5 mg/m2 on Day 1, 29 and 57
IT MTX every 3 months
WBC <1000 1000-2000 2000-3000 >3000
Lymphocytes <300
% MP/MTx dose 0 50 100 Upto 150 50
Interruption of therapy
WCC <1000/ml
Infections
Grade 3 liver toxicity
ALT/AST>5 ULN for age
Bil >3 ULN for age
Long standing diarrhoea