Week of treatment | Treatment |
---|---|
Initial treatment | |
1–2 | Dexamethasone 10 mg/m2 Etoposide 150 mg/m2 on day 1, 4, 8 and 11 Ciclosporin 3 mg/kg twice daily aiming for a trough level 200 mcg/L |
3–4 | Dexamethasone 5 mg/m2 Etoposide 150 mg/m2 weekly Ciclosporin 3 mg/kg twice daily aiming for a trough level 200 mcg/L Intrathecal methotrexate 12 mg with hydrocortisone 50 mg at week 3 (repeat weekly on week 4–6 if evidence of central nervouse system involvement) |
5–6 | Dexamethasone 2.5 mg/m2 Etoposide 150 mg/m2 weekly Ciclosporin 3 mg/kg twice daily aiming for a trough level 200 mcg/L |
7–8 | Dexamethasone 1.25 mg/m2 Etoposide 150 mg/m2 weekly Ciclosporin 3 mg/kg twice daily aiming for a trough level 200 mcg/L |
Continuation therapy | |
9 onwards | Dexamethasone 10 mg/m2 for 3 days every 2 weeks Etoposide 150 mg/m2 every 2 weeks Ciclosporin 3 mg/kg twice daily aiming for a trough level 200 mcg/L |