cyclophosphamide + cytarabine + daunorubicin + mercaptopurine + methotrexate + pegaspargase + prednisone + vincristine

This is a multi‑agent chemotherapy regimen combining the antimetabolites cytarabine, mercaptopurine, and methotrexate; the alkylating agent cyclophosphamide; the anthracycline topoisomerase II inhibitor daunorubicin; the microtubule inhibitor vincristine; the glucocorticoid prednisone; and the pegylated asparagine‑depleting enzyme pegaspargase. It represents an intensive, combination antineoplastic regimen used in acute leukemia protocols, particularly acute lymphoblastic leukemia, exploiting complementary cytotoxic mechanisms across the cell cycle, purine and pyrimidine synthesis, DNA integrity, mitotic spindle function, and leukemic cell dependence on extracellular asparagine to induce deep remissions and provide CNS and systemic disease control.[2][5][6][8]