bortezomib + mitoxantrone + vincristine + pegaspargase + dexamethasone + methotrexate

This combination therapy consists of the proteasome inhibitor bortezomib integrated into the ALL R3 reinduction backbone, which includes mitoxantrone, vincristine, pegaspargase, dexamethasone, and methotrexate. Developed and evaluated in a Phase 2 pilot study by Children's Mercy Hospital Kansas City, this regimen is specifically designed for pediatric and young adult patients with high-risk relapsed or refractory acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LL). Bortezomib works by inhibiting the 26S proteasome, leading to the accumulation of ubiquitinated proteins and subsequent apoptosis, which sensitizes leukemia cells to the cytotoxic effects of the standard chemotherapy agents in the R3 regimen. The regimen utilizes multiple mechanisms, including DNA intercalation, microtubule disruption, and asparagine depletion, to overcome resistance in heavily pretreated lymphoid malignancies.

Other names

Bortezomib + ALL R3 regimenBortezomib with Mitoxantrone-based reinductionVelcade + ALL R3 regimen