NOTE: FOR RITUXIMAB, THE USE OF A BIOSIMILAR OR THE REFERENCE PRODUCT IS ON PATHWAY
| Evolent Pathways | Febrile Neutropenic Risk | Emetogenic Risk | References | ||
|---|---|---|---|---|---|
| INDUCTION & CONSOLIDATION & CNS PROPHYLAXIS (PER REGIMEN PROTOCOL) | |||||
Hyper-CVAD |
High | Moderate |
|
||
Hyper-CVAD and rituximab |
High | Moderate |
|
||
Hyper-CVAD and imatinib *if Ph positive* |
High | Moderate |
|
||
CALGB 10403 (daunorubicin, vincristine, prednisone, pegaspargase) |
High | Moderate |
|
||
CALGB 8811 (daunorubicin, vincristine, prednisone, pegaspargase, cyclophosphamide) |
High | Moderate |
|
||
vincristine, dexamethasone |
Low | Low |
|
||
vincristine, dexamethasone and imatinib *if Ph positive* |
Low | Low |
|
||
blinatumomab and consolidation chemotherapy *MRD-negative remission* |
High | Low |
|
||
| MAINTENANCE | |||||
vincristine, methotrexate, 6-mercaptopurine |
Low | Low |
|
||
vincristine, methotrexate, 6-mercaptopurine and imatinib *if Ph positive* |
Low | Low |
|
||
vincristine, methotrexate, 6-mercaptopurine *if Ph negative* |
Low | Low |
|
||
| RELAPSED/REFRACTORY | |||||
blinatumomab |
High | Low |
|
||
etoposide, ifosfamide and mitoxantrone |
High | Moderate |
|
||
clofarabine |
High | Moderate |
|
||
Hyper-CVAD
Hyper-CVAD and rituximab
Hyper-CVAD and imatinib *if Ph positive*
CALGB 10403 (daunorubicin, vincristine, prednisone, pegaspargase)
CALGB 8811 (daunorubicin, vincristine, prednisone, pegaspargase, cyclophosphamide)
vincristine, dexamethasone
vincristine, dexamethasone and imatinib *if Ph positive*
blinatumomab and consolidation chemotherapy *MRD-negative remission*
vincristine, methotrexate, 6-mercaptopurine
vincristine, methotrexate, 6-mercaptopurine and imatinib *if Ph positive*
vincristine, methotrexate, 6-mercaptopurine *if Ph negative*
blinatumomab
etoposide, ifosfamide and mitoxantrone
clofarabine
| Regimen | Alternative | References | |||
|---|---|---|---|---|---|
| LOW VALUE REGIMENS (NON-PATHWAY) WITH SUPERIOR ALTERNATIVES | |||||
venetoclax + chemotherapy (eg decitabine, hyper-CVAD, nelarabine, mini-hyper-CVD) *for T-cell* |
Alternative: alkylator containing regimens: etoposide, ifosfamide, mitoxantrone |
||||
venetoclax + chemotherapy (eg decitabine, hyper-CVAD, nelarabine, mini-hyper-CVD) *for T-cell*