doxorubicin + methotrexate + cyclophosphamide + L-asparaginase

This is a multi-agent chemotherapy protocol consisting of **doxorubicin**, **methotrexate**, **cyclophosphamide**, and **L-asparaginase**. It is primarily used in the treatment of **lymphoblastic malignancies**, including **acute lymphoblastic leukemia (ALL)** and **lymphoblastic lymphoma**. The combination is part of various established treatment protocols, sometimes with additional agents like vincristine, prednisone, or dexamethasone. These drugs work through different mechanisms: * **Doxorubicin** (also known as Adriamycin) is an anthracycline that intercalates with DNA and inhibits topoisomerase II. * **Methotrexate** is an antimetabolite that inhibits dihydrofolate reductase. * **Cyclophosphamide** is an alkylating agent that cross-links DNA. * **L-asparaginase** depletes asparagine, which leukemic cells cannot synthesize on their own. Treatment typically follows a protocol with distinct phases: induction, consolidation, and maintenance. Side effects can include hematologic toxicity (neutropenia, thrombocytopenia), gastrointestinal toxicity, cardiotoxicity (particularly from doxorubicin), and risk of secondary malignancies. Long-term use requires careful monitoring of cumulative doses, especially for doxorubicin due to potential heart damage. The combination has been used in clinical trials and treatment protocols for both pediatric and adult patients with lymphoblastic malignancies, with complete remission rates reported in various studies.

Other names

Modified Intensive Chemotherapy for Cancer in Children with Ataxia-Telangiectasia