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60

NCCN Guidelines for Patients

®

:

Acute Lymphoblastic Leukemia, Version 1.2017

5

Treatment guide

Older Adults with Ph-negative ALL

Guide 14. Postremission consolidation and maintenance for patients <65 years

of age without serious health problems

MRD results Consolidation therapy options Next options

Persistent or late MRD

ª

• Blinatumomab

• Consider allogeneic SCT

ª

• Start follow-up testing

MRD not found

ª

• Continue multiagent

chemotherapy regimen

ª

• Maintenance therapy with:

• Monthly vincristine/

prednisone pulses

• Weekly methotrexate

• Daily 6-MP

• Consider allogeneic SCT

ª

• Start follow-up testing

MRD unknown

ª

• Allogeneic SCT

• Consider continuing

multiagent chemotherapy

regimen

ª

• After chemotherapy,

maintenance therapy with:

• Monthly vincristine/

prednisone pulses

• Weekly methotrexate

• Daily 6-MP

• After SCT, start follow-up

testing

Guide 13. Postremission consolidation and maintenance Patients ≥65 years

of age or with other serious health problems

Health status Consolidation therapy options Maintenance therapy options

Patients ≥65 years

of age or with other

serious health

problems

ª

• Chemotherapy

ª

• Maintenance therapy with:

• Monthly vincristine/

prednisone pulses

• Weekly methotrexate

• Daily 6-MP