Acute lymphoblastic leukemia, infant

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Are you looking for a regimen but can't find it here? It is possible that we've moved it to the historical regimens page.
This page contains studies that are specific to populations with infant ALL, which is characterized by KMT2A rearrangements. For the more general B-cell pediatric acute lymphoblastic leukemia page, follow this link.
Last updated on 2024-07-23:2 regimens on this page
2 variants on this page
=Guidelines=
Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.
==NCCN==
*NCCN does not currently have guidelines at this granular level; please see NCCN Guidelines - Pediatric Acute Lymphoblastic Leukemia.
=Consolidation=
==Blinatumomab monotherapy==
===Regimen===
Study 	Dates of enrollment	Evidence
van der Sluis et al. 2023	2018-07 to 2021-07 	Phase 2
====Preceding treatment====
*Interfant-06 induction
====Immunotherapy====
*Blinatumomab (Blincyto) 15 mcg/m2/day IV continuous infusion over 28 days, started on day 1
====Supportive therapy====
*Dexamethasone (Decadron) 5 mg/m2 IV once on day 1, given 30 minutes prior to start of blinatumomab infusion
====CNS prophylaxis====
*Methotrexate (MTX) (dose not specified) IT once on day 15
*Prednisolone (Millipred) (dose not specified) IT once on day 15
28-day course
====Subsequent treatment====
*Interfant-06 consolidation
===References===
#van der Sluis IM, de Lorenzo P, Kotecha RS, Attarbaschi A, Escherich G, Nysom K, Stary J, Ferster A, Brethon B, Locatelli F, Schrappe M, Scholte-van Houtem PE, Valsecchi MG, Pieters R. Blinatumomab Added to Chemotherapy in Infant Lymphoblastic Leukemia. N Engl J Med. 2023 Apr 27;388(17):1572-1581. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC EudraCT 2016-004674-17
==Cyclophosphamide, Etoposide, Methotrexate==
===Regimen===
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy
Dreyer et al. 2014 (COG P9407) 	2001-2006 	Non-randomized	 	
Brown et al. 2021 (COG AALL0631)	2008-2014 	Phase 3 (C) 	Cyclophosphamide, Etoposide, Lestaurtinib, Methotrexate	Did not meet primary endpoint of EFS
====Biomarker eligibility criteria====
*COG AALL0631: KMT2A rearrangement
====Preceding treatment====
*Induction
====Chemotherapy====
*Cyclophosphamide (Cytoxan) 300 mg/m2 IV over 30 minutes once per day on days 15 to 19
*Etoposide (Vepesid) 100 mg/m2 IV over 2 hours once per day on days 15 to 19
*Methotrexate (MTX) 200 mg/m2 IV over 20 minutes, then 3800 mg/m2 IV continuous infusion over 23.67 hours, repeated on days 1 & 8 (total dose: 8000 mg/m2)
6-week course
====Subsequent treatment====
*Reinduction
===References===
#COG P9407: Dreyer ZE, Hilden JM, Jones TL, Devidas M, Winick NJ, Willman CL, Harvey RC, Chen IM, Behm FG, Pullen J, Wood BL, Carroll AJ, Heerema NA, Felix CA, Robinson B, Reaman GH, Salzer WL, Hunger SP, Carroll WL, Camitta BM. Intensified chemotherapy without SCT in infant ALL: results from COG P9407 (Cohort 3). Pediatr Blood Cancer. 2015 Mar;62(3):419-26. Epub 2014 Nov 14. link to original article link to PMC article EuroPMC NCT00002756
#COG AALL0631: Brown PA, Kairalla JA, Hilden JM, Dreyer ZE, Carroll AJ, Heerema NA, Wang C, Devidas M, Gore L, Salzer WL, Winick NJ, Carroll WL, Raetz EA, Borowitz MJ, Small D, Loh ML, Hunger SP. FLT3 inhibitor lestaurtinib plus chemotherapy for newly diagnosed KMT2A-rearranged infant acute lymphoblastic leukemia: Children's Oncology Group trial AALL0631. Leukemia. 2021 May;35(5):1279-1290. Epub 2021 Feb 23. Erratum in: Leukemia. 2021 Apr 12. link to original article dosing details in supplement have been reviewed by our editors link to PMC article EuroPMC NCT00557193
Category:Acute lymphoblastic leukemia, infant regimens
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Category:Acute lymphoblastic leukemias
Category:Pediatric hematologic neoplasms