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©2013 UpToDate ® Print Email Intensive treatment for Burkitt leukemia/lymphoma: CALGB 9251 (revised*) Cycle 1 • Cyclophosphamide: 200 mg/m 2 IV per day on days 1 through 5 Prednisone: 60 mg/m 2 PO per day on days 1 through 7 Cycles 2, 4, and 6 • Ifosfamide: 800 mg/m 2 over one hour IV per day on days 1 through 5 Mesna: 200 mg/m 2 IV per day on days 1 through 5 at 0, 4, and 8 hours after ifosfamide Methotrexate: 150 mg/m 2 IV over 30 minutes on day 1, then 1.35 g/m 2 IV over the next 23.5 hours, for a total dose of 1.5 g/m 2 Leucovorin: 50 mg/m 2 IV 36 hours after initiation of methotrexate, then 15 mg/m 2 every 6 hours until serum methotrexate concentration <0.05 micromolar Vincristine: 2 mg IV push on day 1 Cytarabine: 150 mg/m 2 per day by continuous IV infusion on days 4 and 5 Etoposide: 80 mg/m 2 per day IV over one hour on days 4 and 5 Dexamethasone: 10 mg/m 2 PO per day on days 1 through 5 Cycles 3, 5, and 7 Cyclophosphamide: 200 mg/m 2 per day IV on days 1 through 5 Methotrexate: 150 mg/m 2 IV over 30 minutes on day 1, then 1.35 g/m 2 IV over the next 23.5 hours, for a total dose of 1.5 g/m 2 Leucovorin: 50 mg/m 2 IV 36 hours after initiation of methotrexate, then 15 mg/m 2 every 6 hours until serum methotrexate concentration <0.05 micromolar Vincristine: 2 mg IV push on day 1 Doxorubicin: 25 mg/m 2 per day by IV bolus on days 4 and 5 Dexamethasone: 10 mg/m 2 PO per day on days 1 through 5 Intrathecal chemotherapy with cycles 2 through 7 (amended) Methotrexate: 15 mg IT on day 1 Cytarabine: 40 mg IT on day 1 Hydrocortisone: 50 mg IT on day 1 Cranial irradiation (amended) 2400 cGy administered in 12 fractions after chemotherapy for cycle 7 completed, only for patients who had prior bone marrow involvement at the time of presentation CALGB: Cancer and Leukemia Group B; IV: intravenously; PO: by mouth; IT: intrathecal injection. * Revised protocol as given to Cohort 2 of the study in order to reduce the incidence and severity of neurotoxicity. • All cycles are repeated at 21-day intervals except cycle 1, which lasts 7 days. Modified from: Lee, EJ, et al. J Clin Oncol 2001; 19:4014 and Rizzieri, DA, et al. Cancer 2004; 100:1438.