Table 1 Individual Drugs Used in Common SOC Chemotherapy in Newly Diagnosed Adult Patients With Ph-Negative BCP-ALL.

From: Frontline Ph-negative B-cell precursor acute lymphoblastic leukemia treatment and the emerging role of blinatumomab

Chemotherapeutic Agent

Common Regimen

Country

Vinca Alkaloid

Anthracycline

Corticosteroid

Asparaginase

Alkylating Agent

Antimetabolite

Topoisomerase Inhibitor

Rituximab*

CALGB 10403 [69]

US

Vincristine

Daunorubicin

Doxorubicin

Prednisone

Dexamethasone

Pegaspargase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine (systemic and IT)

6-mercaptopurine

6-thioguanine

  

DFCI ALL [70]

US

Vincristine

Doxorubicin

Prednisone

Dexamethasone

Hydrocortisone (IT)

Asparaginase

 

Methotrexate (systemic and IT)

Cytarabine (IT)

6-mercaptopurine

  

PETHEMA ALL-96 [71]

Spain

Vincristine

Daunorubicin

Prednisone

Dexamethasone

Hydrocortisone (IT)

Asparaginase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine (systemic and IT)

6-mercaptopurine

Teniposide

 

Hyper-CVAD [72]

US/Australia

Vincristine

Doxorubicin

Prednisone

Dexamethasone

Methylprednisolone

 

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine (systemic and IT)

6-mercaptopurine

  

USC/MSKCC ALL [73]

US

Vincristine

Daunorubicin

Prednisone

Dexamethasone

Pegaspargase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine

6-mercaptopurine

6-thioguanine

Teniposide

 

Linker 4-drug regimen [74]

US

Vincristine

Daunorubicin

Prednisone

Asparaginase

 

Methotrexate (systemic and IT)

Cytarabine

6-mercaptopurine

Etoposide

 

CALGB 8811 Larson [75]

US

Vincristine

Daunorubicin

Doxorubicin

Prednisone

Dexamethasone

L-asparaginase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine

6-mercaptopurine

6-thioguanine

  

MRC UKALLXII/ ECOG2993 [76]

US/UK

Vincristine

Daunorubicin

Prednisone

Dexamethasone

L-asparaginase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine

6-mercaptopurine

6-thioguanine

Etoposide

 

Modified DFCI-01 [40]

Canada

Vincristine

Doxorubicin

Dexamethasone

Asparaginase

 

Methotrexate (systemic and IT)

Cytarabine

6-mercaptopurine

  

GRAALL-2005 [77]

France

Vincristine

Daunorubicin

Prednisone

Dexamethasone

Methylprednisolone (IT)

L-asparaginase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine (systemic and IT)

6-mercaptopurine

Etoposide

Rituximab

GRAALL-2014 [77, 78]

France

Vincristine

Daunorubicin

Prednisone

Dexamethasone

Methylprednisolone (IT)

L-asparaginase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine (systemic and IT)

6-mercaptopurine

Etoposide

 

GMALL [12, 79]

Germany

Vincristine

Idarubicin

Dexamethasone

Pegaspargase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine

6-mercaptopurine

 

Rituximab

GIMEMA LAL 1913 [60]

Italy

Vincristine

Idarubicin

Prednisone

Dexamethasone (systemic and IT)

Pegaspargase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine (systemic and IT)

6-mercaptopurine

Dexamethasone (IT)

  

HOVON-100 [61]

Netherlands, Belgium, France

Vincristine

Vindesine

Daunorubicin

Doxorubicin

Prednisone

Dexamethasone

Pegaspargase

 

Methotrexate (systemic and IT)

Cytarabine

6-mercaptopurine

6-thioguanine

Etoposide

 

UKALL14 [80]

UK

Vincristine

Daunorubicin

Prednisolone

Dexamethasone

Pegaspargase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine

6-mercaptopurine

Etoposide

Rituximab

JALSG 202-0 [81]

Japan

Vincristine

Daunorubicin

Doxorubicin

Prednisolone

Dexamethasone (systemic and IT)

L-asparaginase

Cyclophosphamide

Methotrexate (systemic and IT)

Cytarabine (systemic and IT)

6-mercaptopurine

Etoposide

 
  1. Doses of individual agents used in these chemotherapy regimens are dependent on patient age, risk group, and other characteristics; therefore, individual adaptations to dose are common.
  2. *With rituximab for CD20-positive disease.
  3. For AYA population and for adults < 65 years without substantial comorbidities.
  4. ALL acute lymphoblastic leukemia, AYA adolescents and young adults, BCP-ALL B-cell precursor acute lymphoblastic leukemia, DFCI Dana-Farber Cancer Institute, GIMEMA Gruppo Italiano Malattie Ematologico dell’Adulto, GMALL German Multicenter Study Group in Adult ALL, GRAALL Group for Research on Adult Acute Lymphoblastic Leukemia, HOVON Haemato Oncology Foundation for Adults in the Netherlands, IT intrathecal, PH Philadelphia chromosome, SOC standard of care.