Leukemia Treatment Plan (ALL B-Cell)

I was recently conversing on-line with another mother of a child with Leukemia. We were comparing treatment plans and discussing our daughters. The medications involved in treatment were very similar, but it was difficult to determine how similar or different the plans actually were. I was under the impression that treatment was fairly standardized. From what I understood, protocols are developed in Germany and used throughout the world. After my conversations with her, I'm not sure about the level of standardization. Perhaps the differences are due to slight differences in diagnosis or perhaps they are due to the doctor treating the condition. Either way, I thought I would spell out Jemma's treatment plan.

She has Acute Lymphoblastic Leukemia (ALL) B-Cell, and is in the medium risk group. Treatment lasts 24 months. The first six months are intensive, the following 18 months are known as maintenance. The intensive treatment plan consists of five phases with breaks between each one.

Protocol 1A - Induction - 33 days
Protocol 1B - 28 days
Protocol M - 56 days
Protocol 2A - 29 days
Protocol 2B - 14 days

List of Medications
PRED Predsone
VCR VinCRIStine
DNR Donorubicin
MTX spinal tap Methotrexate
PEG-L-ASP Pegaspargase
CPM Cyclophosphamide
ARA-C Alexan
6-MP Mercaptopurine
iv MTX Methotrexate
LCV-Rescue
DEXA Dexamethasone
DOX Doxorubicin
TG

List of Medications to combat Symptoms caused by Chemotherapy medications

The following are used during the entire course of treatment:
Kepinol (Sulfamethoxazol) - "Weekend Antibiotics" Taken twice daily each Saturday and Sunday during her entire treatment
Special Mouth Wash - To be used 3 to 4 times per day to protect the mouth and teeth during the entire treatment. The mouthwash is a mix of oils such as olive, geranium and mint. We put two drops into a small amount of water for her to use after brushing.
 

These medications are taken only in conjunction with specific protocols:
Protocol 1A
Diflucan - Taken daily to prevent fungus infections
Antra - Taken daily to protect the stomach

Protocol 1B
Zofran - Taken on days when Alexan is given to prevent nausea

Protocol M
Zofran - Given over the iv during Methotrexate treatments to prevent nausea

Protocol 2A
Pantoprazol - Taken to protect the stomach.

Protocol 2B
I will update this when Jemma is in protocol 2A, but it should be similar to protocol 1B.



* Blue highlighting indicates inpatient hospital visits.
* Yellow highlighting indicates 9 additional doses of the drug PEG-L-ASP (Pegaspargase), Jemma is scheduled to receive as part of a study. The study will determine if the additional doses reduce Leukemia relapse rates.
* We haven't followed the planned number of days exactly, due to illness and time required for Jemma's blood to recover from chemotherapy.