see the Deborah A. Thomas, Treatment of Philadelphia chromosome–positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate. Blood, Jun 2004; 103: 4396 - 4407. We use the chemotherapy and in case of Ph+ALL we add Gleevec or other TKInhibitors.
There is a good publication on Augmented Hyper-CVAD that combines Hyper-CVAD with Peg-Aps (and much more steroids than classical Hyper-CVAD). This is associated with toxicities (mainly sepsis/necrotising fascitis!). We at SQUH Oman usu the classical Hyper-CVAD augmented with Peg-Aps (2500 units/m2 I.V.) on Day 1 of A part and Day 5 of B part and i think it is of major benefit based on previous studies assessing the addition of peg asp to a number of protocols.