Clinical scenario

Acute lymphoblastic leukemia (ALL) is an aggressive hematologic malignancy managed in sequential treatment phases. This protocol covers the consolidation phase of first-line therapy — a critical stage designed to deepen and sustain remission following induction.

Treatment approach (partial overview)

Consolidation in this setting involves rotational multidrug cycles, incorporating CNS-penetrating agents, delivered across multiple courses over an extended period. The complete regimen — including specific agents, sequencing, and course structure — is contained in the full protocol.

References

DOI: 10.1182/blood.2023023568

Outcome is best with rotational multidrug cycles consisting of HD-MTX and HD-AC (also useful as CNS-penetrating agent), PEG-ASP and other drugs (supplemental Table 2).
The average duration of consolidation is ≥6 months, for 6 to 8 total courses.
HD-AC, HD-MTX, etoposide, and CP were essential to improve outcome of high-risk subsets and T-ALL.
HD-AC (4-8 doses at 1-3 g/m2), PEG-ASP and HD-MTX (1-1.5 g/m2, followed by folinic acid rescue) are administered in blocks.

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First-Line Consolidation Treatment for Acute Lymphoblastic Leukemia

References