Systemic Anti-Cancer Therapy Regimen Library
LEU ALL precursor T-cell - GMALL T-LBL 1/2004 [55 years and under]
Treatment Overview
GMALL T-LBL 1/2004 [55 years and under] is intended for patients 55 years and under.
This regimen consists of:
- Pre-phase and Induction I and II, followed by
- Consolidation I, commencing week 11 (day 71)
- HDMTX/ASP, commencing week 16
- Reinduction I and II, commencing week 22
- HDMTX/ASP, commencing week 30
- VM26/ARAC, commencing week 36
- CYCLO/ARAC, commencing week 41
- HDMTX/ASP, commencing week 46
- Intrathecal Triple Prophylaxis, in week 52.
See Overview plan in Additional details.
Pre-phase [days 1 to 5] followed immediately by Induction I [days 6 to 20] then Induction II [days 26 to 46].
All patients receive prophylactic cranial radiotherapy parallel to Induction II [days 26 to 46] – see protocol for details.
Patients with initial mediastinal tumour receive mediastinal radiotherapy as soon as possible after blood regeneration after Induction II [days 26 to 46] – see protocol for details.
Commencing week 11 (day 71).
Commencing week 16, week 30, and week 46.
Commencing week 22 Reinduction I [days 1 to 14] then Reinduction II [days 15 to 28].
Commencing week 36.
Commencing week 41.
Additional details
Section 1: Overview Plan
Overview Plan from: Multicenter Study for T-lymphoblastic Lymphoma in Adults (> 15 years) GMALL T-LBL 1/2004 Protocol Synopsis Version : 21. May 2004 Principal Investigator Prof.Dr.D.Hoelzer.
Supportive Care Factors
| Factor | Value |
|---|---|
| Antifungal prophylaxis: | Routine antifungal prophylaxis recommended |
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis recommended |
| Constipation risk: | Variable |
| Emetogenicity: | Variable |
| Folinic acid rescue for high dose methotrexate: | Variable |
| Gastroprotection: | Variable |
| Growth factor support: | Variable |
| Hydration: | Variable |
| Hypersensitivity / Infusion related reaction risk: | Variable |
| Pneumocystis jirovecii pneumonia (PJP) prophylaxis: | Routine antibiotic prophylaxis recommended |
| Tumour lysis syndrome prophylaxis: | Variable |
Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.
Gastroprotection: Gastroprotection agents are only intended for short term use while patient is receiving corticosteroid treatment doses.
References
Multicenter Study for T-lymphoblastic Lymphoma in Adults (> 15 years) GMALL T-LBL 1/2004 Protocol Synopsis Version : 21. May 2004 Principal Investigator Prof.Dr.D.Hoelzer.
WG Critical Care, LLC tenoposide injection prescribing information Reference ID: 3708805 3/2015 https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/020119s013lbl.pdf (accessed 11 October 2022).
Servier Laboratories NZ Ltd Oncaspar®New Zealand data sheet 25 August 2022 https://www.medsafe.govt.nz/profs/datasheet/o/oncasparinj.pdf (accessed 7 February 2023).
Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.
* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.
s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.