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Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)

  • Updated: 04/11/2013

Table 2. CNS-Directed Treatment Regimens for Newly Diagnosed Childhood ALL

Disease Status Standard Treatment Options 
ALL = acute lymphoblastic leukemia; CNS = central nervous system; CNS3 = cerebrospinal fluid with 5 or more white blood cells/µL and cytospin positive for blasts.
Standard-risk ALL Intrathecal chemotherapy
Methotrexate alone
Methotrexate with cytarabine and hydrocortisone
CNS-penetrant systemic chemotherapy
Dexamethasone
L-asparaginase
High-dose methotrexate with leucovorin rescue
High-risk ALL Intrathecal chemotherapy
Methotrexate alone
Methotrexate with cytarabine and hydrocortisone
CNS-penetrant systemic chemotherapy
Dexamethasone
L-asparaginase
High-dose methotrexate with leucovorin rescue
Cranial radiation