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NCCN Guidelines for Patients



Acute Lymphoblastic Leukemia, Version 1.2017


Treatment guide

Older Adults with Ph-negative ALL

Maintenance therapy is given to keep up (maintain)

the good results of prior treatments. The goal is to

prevent a relapse after induction and consolidation

therapy. A relapse is when leukemia cells come back

after a complete remission.

If you are not treated with an allogeneic SCT, you will

likely be treated with a maintenance chemotherapy

regimen for 2 to 3 years. Maintenance therapy drugs

are often given in lower doses and cause fewer

side effects. CNS preventive treatment can also be

given throughout this treatment phase. This regimen

may include weekly methotrexate, daily 6-MP,

monthly vincristine, and a steroid (prednisone or

dexamethasone). Methotrexate and 6-MP can affect

the liver or lead to low blood counts, and may require

dose reduction or discontinuation.

Next steps

After the allogeneic SCT or after completing

consolidation and maintenance therapy, see Guide

15 for follow-up testing.