B-ALL protocol

The B-ALL protocol is an intensive, multi-agent chemotherapy regimen originally developed for Burkitt lymphoma and later evaluated as an escalation strategy for aggressive non-Hodgkin's lymphoma (NHL). In the Phase 3 PETAL trial, led by University Hospital Essen, this protocol was administered to patients who showed a positive interim PET scan after two cycles of R-CHOP. The regimen consists of six blocks of intensive chemotherapy including rituximab, methotrexate, ifosfamide, etoposide, cytarabine, vincristine, cyclophosphamide, doxorubicin, vindesine, and dexamethasone. The trial was terminated early for futility as the B-ALL protocol failed to improve event-free survival compared to standard R-CHOP and was associated with significantly higher toxicity.