What is the CALGB 8811 regimen for acute lymphoblastic leukemia (ALL)?

Updated: Oct 23, 2019
  • Author: Karen Seiter, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Answer

Answer

The CALGB 8811 ALL regimen includes the following [1] :

Course I – Induction (4 wk):

  • Cyclophosphamide 1200 mg/m2 (800 mg/m2 if patients older than 60 y) IV on day 1 plus daunorubicin 45 mg/m2/day (30 mg/m2/day if patients older than 60 y) IV on days 1-3 plus vincristine 2 mg IV on days 1, 8, 15, and 22 plus prednisone 60 mg/m2/day PO on days 1-21 (days 1-7 if patients older than 60 y)

  • The CALGB 8811 ALL induction regimen also includes L-asparaginase 6000 U/m2 SC on days 5, 8, 11, 15, 18, and 22; however, L-asparaginase is no longer commercially available

Course II – Early intensification (4 wk/cycle, for two cycles):

  • Intrathecal methotrexate 15 mg on day 1 plus  cyclophosphamide 1000 mg/m2 IV on day 1 plus 6-mercaptopurine 60 mg/m2/day PO on days 1-14 plus cytarabine 75 mg/m2/day SC on days 1-4 and 8-11 plus  vincristine 2 mg IV on days 15 and 22 plus  L-asparaginase 6000 IU/m2 SC on days 15, 18, 22, and 25 (no longer commercially available)

Course III – CNS prophylaxis and interim maintenance (12 wk):

  • Cranial radiation 2400 cGy on days 1-12 plus  intrathecal methotrexate 15 mg on days 1, 8, 15, 22, and 29 plus  6-mercaptopurine 60 mg/m2/day PO on days 1-70 plus  methotrexate 20 mg/m2 PO on days 36, 43, 50, 57, and 64

Course IV – Late intensification (8 wk):

  • Daunorubicin 30 mg/m2 IV on days 1, 8, and 15 plus  vincristine 2 mg IV on days 1, 8, and 15 plus  dexamethasone 10 mg/m2/day PO on days 1-14 plus  cyclophosphamide 1000 mg/m2 IV on day 29 plus 6-thioguanine 60 mg/m2/day PO on days 29-42 plus  cytarabine 75 mg/m2/day SC on days 29-32 and 36-39

Course V – Prolonged maintenance (until 24 mo from diagnosis):

  • Vincristine 2 mg IV on day 1 plus  prednisone 60 mg/m2/day PO on days 1-5 plus  methotrexate 20 mg/m2 PO on days 1, 8, 15, and 22 plus  6-mercaptopurine 80 mg/m2/day PO on days 1-28; repeat all every 4wk


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