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.

Whole process is 2.5-3.5 years!!!!

Trial - Michelle will participate in a phase III Clinical  Trial.

Michelle's random selection resulted in the DEXAMETHASOME arm of the study below.

Phase III Randomized Study of Dexamethasone Versus Prednisone During Induction and High-Dose Methotrexate With Leucovorin Rescue Versus Escalating-Dose Methotrexate Without Leucovorin Rescue During Interim Maintenance I in Patients With Newly Diagnosed High-Risk Acute Lymphoblastic Leukemia

The link above is broken.  Search for COG-AALL0232 to find information on her study.  As a note the outcome was the study was closed early due to success and standard treatment protocol modified.