THIS PROTOCOL IS FOR RESEARCH PURPOSES ONLY, SEE PAGE 1 FOR USAGE POLICY AALL0232

4.10.1 INTERIM MAINTENANCE II

Interim Maintenance II (IM2) is 8 weeks (56 days) and is for SER patients and/or ____________________________
patients non-randomly assigned to augmented therapy (CNS3, steroid pre-treated, testicular) Patient name or initials
____________________________
only. Note: Patients with Down syndrome do NOT participate in this phase of therapy.
DOB
Section 4.10 for therapy interruption
guidelines. This Therapy Delivery Map is on one (1) page.

DRUG ROUTE DOSAGE DAYS IMPORTANT NOTES OBSERVATIONS

VinCRIStine (VCR) IV push over 1.5 mg/m2/dose Days 1, 11, + Or infusion via minibag a. Hx, phys, wgt
1 min+ 21, 31 & 41 as per institutional policy b. CBC (diff/plts)
Maximum dose: 2 mg c. CSF! cell count,
cytospin
Methotrexate (MTX) IV push DH & PH: Days 1, 11, See Section 4.10 for
d. Bili, creatinine,
Starting dose is 100 mg/m2 21, 31 & 41 administration guidelines ALT
escalate by 50 mg/m2/dose
! Obtain with each IT
DC & PC: administration
Starting dose is less by
OBTAIN OTHER
50 mg/m than the MAX
STUDIES AS
TOLERATED DOSE in IM1. REQUIRED FOR
Then escalate as tolerated GOOD PATIENT
PEG-asparaginase IM (may 2500 International units/m2/dose Days 2 & See Section 4.10 for CARE
(PEG-ASP) give IV over 22 administration guidelines
1-2 hours)
Intrathecal IT Age (yrs) Dose Days 1 & See Section 4.10 for
Methotrexate 1-1.99 8 mg 31 administration guidelines
(IT MTX) 2-2.99 10 mg
3-8.99 12 mg Note age-based dosing
15 mg

Therapy Delivery Map Ht_________cm Wt________kg BSA________m2

Date Date Day VCR IV MTX PEG-ASP IT MTX Studies Comments
Due Given ____mg ____mg ____IU _____mg
(escalating dose)
Enter calculated dose above and actual dose administered below
1 ____mg ____mg ____mg a, b, c, d
2 ____IU
---
11 ____mg ____mg b, d
---
21 ____mg ____mg b, d
22 ____IU
---
31 ____mg ____mg ____mg b, c, d
---
41 ____mg ____mg b, d
---
51 b, d
57 Begin next course (Delayed Intensification II, Section 4.11) on
Day 57 or when blood count parameters are met (whichever
occurs later).

SEE PROTOCOL SECTION 5.0 FOR DOSE MODIFICATIONS. SEE SECTION 8.0 FOR SUPPORTIVE CARE,
and in particular Section 8.1 regarding evaluation of osteonecrosis (ON).
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