What is the modified LSA2 L2 protocol for the treatment of pediatric lymphoblastic lymphoma?

Updated: Jun 14, 2018
  • Author: J Martin Johnston, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

Between 1986 and 1989, 143 subjects with lymphoblastic lymphoma (10% with localized disease) received treatment with a modified LSA2 L2 regimen in a Children's Cancer Group trial (see Table 1, below). Their 5-year event-free survival rate was 74%. [61]

Table 1. Modified LSA2 L2 Therapy in Children's Cancer Group Protocol 552 (Open Table in a new window)

Phase

Drug

Route

Induction

Cyclophosphamide, vincristine, daunorubicin

IV

Ara-C, methotrexate

IT

Prednisone

PO

Consolidation

Ara-C

IV or SC

6-thioguanine

PO

Methotrexate

IT

L-asparaginase

IM

BCNU

IV

Phase

Cycle

Drug

Route

Maintenance*

1

6-thioguanine

PO

Cyclophosphamide

IV

2

Hydroxyurea

PO

Daunorubicin

IV

3

Methotrexate

PO

BCNU

IV

4

Ara-C

IV or SC

Vincristine

IV

Source: Children's Cancer Group

Ara-C = cytarabine; BCNU = 1,3-bis(2-chloroethyl)-1-nitrosourea, or carmustine; IM = intramuscular; IT = intrathecal; IV = intravenous; PO = oral; SC = subcutaneous

* A minimum of 5 repeated courses (total duration of therapy >18 mo) are noted. Each course of intrathecal methotrexate (day 0 of each course) consists of 4 cycles of rotating drug pairs that are administered every 2 weeks after blood counts have recovered.


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