modified GRAALL-2003 regimen

The modified GRAALL-2003 regimen is a pediatric-inspired, multi-agent chemotherapy protocol designed for the treatment of newly diagnosed Philadelphia chromosome-negative (Ph-negative) acute lymphoblastic leukemia (ALL) in young adults. Originally developed by the Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL) as the GRAALL-2003 protocol, this regimen has been modified by institutions such as The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) to optimize efficacy and reduce treatment-related toxicities in adult populations. The regimen typically consists of a multi-phase treatment schedule including a steroid prephase, a five-drug induction phase (comprising prednisone, vincristine, L-asparaginase or pegaspargase, daunorubicin, and cyclophosphamide), intensive consolidation blocks (incorporating methotrexate, cytarabine, and mercaptopurine), delayed intensification, and a prolonged maintenance phase, alongside central nervous system (CNS) prophylaxis. By utilizing higher cumulative doses of non-myelotoxic agents like vincristine, corticosteroids, and asparaginase, the regimen aims to replicate the superior outcomes observed in pediatric ALL protocols while managing the higher risk of toxicity in adult patients.

Other names

modified GRAALL-2003modified GRAALL-2003 chemotherapy regimenmodified GRAALL-2003 protocol