Induction Therapy - Chemo to kill the leukemia in the bone marrow and spinal fluid. (4-6 weeks)
Arm I: Patients receive
- intrathecal (IT) cytarabine on day 1
- vincristine IV and daunorubicin IV on days 1, 8, 15, and 22
- oral or IV dexamethasone twice daily on days 1-14
- IT methotrexate (MTX) on days 8 and 29
- pegaspargase intramuscularly (IM) once on day 4
Intrathecal Chemotherapy (IT)
During all three phases of chemotherapy treatment, many patients receive extra chemotherapy to destroy leukemia cells that may have spread to the central nervous system (the brain and spinal cord). This chemotherapy is injected right into the spinal fluid using a lumbar puncture (spinal tap) or an Omaya reservoir (a device placed under the scalp). It is called intrathecal chemotherapy.
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