Treatment for Patients with Intermediate-Risk, Unfavorable Biology
These patients should receive an additional four cycles of chemotherapy in course II as follows:
Course number Cycle number Day Agents (in doses listed earlier)
II 5 84-86 Repeat chemotherapy drugs in cycle 3
6 105 Repeat cycle 2
7 126-128 Repeat cycle 1
Growth factors (G-CSF or GM-CSF) should be given for infants less than 60 days of age. Older infants and children may also receive growth factors. G-CSF 5 mg/kg/day Subcutaneously (SC) or GM-CSF 250 mg/m2/day SC starting 24 hours after chemotherapy administration until the absolute neutrophil count is >1,000/pL for 2 consecutive days. Estimated 3-year relapse-free survival is 75-98%.
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