What does the CCCG ALL Multi-Agent Chemotherapy protocol involve?

This is a risk-stratified, 2.5-year chemotherapy regimen for pediatric acute lymphoblastic leukemia (ALL). It uses multiple chemotherapeutic agents in phases: induction, consolidation, interim maintenance, delayed intensification, and long-term maintenance. Treatment is tailored to the child’s risk group (standard, high, or very high) based on genetic and clinical factors. The protocol aims to eradicate leukemic cells while minimizing long-term toxicity, with the maintenance phase typically managed on an outpatient basis.