Cancers & treatments·Regimen libraryCurative

Hyper-CVAD

Checked 2026-09-09

Adult acute lymphoblastic leukaemia (with a tyrosine kinase inhibitor if Philadelphia-positive), Burkitt lymphoma and younger patients with mantle cell lymphoma

Also called hyperCVAD, Hyper-CVAD/MA.

One cycle

every 21 days × 8 · about 24 weeks in total

21-day cycle × 8 (alternating A and B courses) (about 24 weeks)IntravenousOral Continuous infusion Daily oral course

Components

Drug	Dose	Route	Days
Cyclophosphamide (course A) Alkylating agent (oxazaphosphorine prodrug)	300 mg/m² every 12 hours for 6 doses, with mesna	IV	D1-3
Vincristine (course A) Vinca alkaloid (microtubule inhibitor)	2 mg	IV	D4, 11
Doxorubicin (course A) Cytotoxic chemotherapy (anthracycline)	50 mg/m²	IV	D4
Dexamethasone (course A) Glucocorticoid	40 mg daily	Oral	D1, 2, 3, 4, 11, 12, 13, 14
Methotrexate (course B) Antifolate (DHFR inhibitor)	1,000 mg/m² with leucovorin rescue	IV	D1 (24 h infusion)
Cytarabine (course B) Pyrimidine nucleoside analogue (antimetabolite)	3,000 mg/m² every 12 hours for 4 doses	IV	D2, 3

Cycles

8 (alternating A and B courses)

21-day cycle

Emetogenicity

High (>90%)

G-CSF

Built into the protocol

Notes

Courses A (hyper-CVAD) and B (high-dose methotrexate and cytarabine) alternate; intrathecal prophylaxis is given with each course.
Cytarabine dose is reduced for age over 60 or renal impairment.

Used in

Acute lymphoblastic leukaemia Mantle cell lymphoma Burkitt lymphoma

Products

CyclophosphamideVincristineDoxorubicinDexamethasoneMethotrexateCytarabine

Source

Kantarjian, JCO 2000: hyper-CVAD in adult ALL

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.