Anaplastic large cell lymphoma, pediatric - historical

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the main pediatric anaplastic large cell lymphoma page for current regimens.
Last updated on 2024-10-04:2 regimens on this page
2 variants on this page
=All lines of therapy=
==EICNHL ALCL99 protocol==
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy 	Comparative Toxicity
Brugières et al. 2009 (EICNHL ALCL99)	1999-2005 	Randomized (E-switch-ic)	EICHNL ALCL99; alternate MTX dosing	Inconclusive whether non-inferior EFS (primary endpoint)	Less toxic
Note: the intrathecal component is only described as "triple therapy" in the manuscript.
===Pre-phase===
====Chemotherapy====
*Cyclophosphamide (Cytoxan) 200 mg/m2 IV once per day on Days 1 & 2
====Glucocorticoid therapy====
*Dexamethasone (Decadron) 5 mg/m2/day PO on days 1 & 2, then 10 mg/m2/day PO on Days 3 to 5
====CNS therapy, prophylaxis====
*Methotrexate (MTX) (dose not specified) IT once on Day 1
*Cytarabine (Ara-C) (dose not specified) IT once on Day 1
*Hydrocortisone (Cortef) (dose not specified) IT once on Day 1
5-day course
===Induction===
====Chemotherapy====
*Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on Day 1
*Ifosfamide (Ifex) as follows:
**Cycles 1, 3, 5: 800 mg/m2 IV once per day on Days 1 to 5
*Etoposide (Vepesid) as follows:
**Cycles 1, 3, 5: 100 mg/m2 IV once per day on Days 4 & 5
*Cytarabine (Ara-C) as follows:
**Cycles 1, 3, 5: 150 mg/m2 IV every 12 hours on Days 4 & 5 (total dose per cycle: 600 mg/m2)
*Cyclophosphamide (Cytoxan) as follows:
**Cycles 2, 4, 6: 200 mg/m2 IV once per day on Days 1 to 5
*Doxorubicin (Adriamycin) as follows:
**Cycles 2, 4, 6: 25 mg/m2 IV once per day on Days 4 & 5
====Glucocorticoid therapy====
*Dexamethasone (Decadron) 10 mg/m2/day PO on Days 1 to 5
21-day cycle for 6 cycles
===References===
#EICNHL ALCL99: Brugières L, Le Deley MC, Rosolen A, Williams D, Horibe K, Wrobel G, Mann G, Zsiros J, Uyttebroeck A, Marky I, Lamant L, Reiter A. Impact of the methotrexate administration dose on the need for intrathecal treatment in children and adolescents with anaplastic large-cell lymphoma: results of a randomized trial of the EICNHL Group. J Clin Oncol. 2009 Feb 20;27(6):897-903. Epub 2009 Jan 12. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC NCT00006455
==APO==
APO: Adriamycin (Doxorubicin), Prednisone, Oncovin (Vincristine)
HOP: Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone
===Regimen===
Study 	Dates of enrollment	Evidence
Alexander et al. 2014 (COG ANHL0131)	2004-2008 	Non-randomized part of phase 3 RCT
====Chemotherapy====
*Doxorubicin (Adriamycin) 75 mg/m2 IV once per day on Days 1 & 22
*Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV once per day on Days 1, 8, 15, 22, 29
====Glucocorticoid therapy====
*Prednisone (Sterapred) 40 mg/m2/day PO on Days 1 to 28
====CNS therapy, prophylaxis====
*Methotrexate (MTX) age-adjusted IT once per day on Days 1, 8, 22
6-week course
====Subsequent treatment====
*APO versus APV maintenance
===References===
# COG ANHL0131: Alexander S, Kraveka JM, Weitzman S, Lowe E, Smith L, Lynch JC, Chang M, Kinney MC, Perkins SL, Laver J, Gross TG, Weinstein H. Advanced stage anaplastic large cell lymphoma in children and adolescents: results of ANHL0131, a randomized phase III trial of APO versus a modified regimen with vinblastine: a report from the children's oncology group. Pediatr Blood Cancer. 2014 Dec;61(12):2236-42. Epub 2014 Aug 23. link to original article link to PMC article dosing details in manuscript have been reviewed by our editors EuroPMC NCT00059839