idarubicin + methotrexate + L-asparaginase + dexamethasone

This is a multi-agent chemotherapy regimen composed of four drugs: - **Idarubicin** is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, leading to DNA damage and apoptosis in rapidly dividing cells. - **Methotrexate** is an antimetabolite and antifolate agent that inhibits dihydrofolate reductase, blocking DNA synthesis, repair, and cellular replication. - **L-asparaginase** is an enzyme that hydrolyzes asparagine to aspartic acid and ammonia, depleting extracellular asparagine required by certain leukemic cells for survival. - **Dexamethasone** is a synthetic glucocorticoid with anti-inflammatory and immunosuppressant properties; it induces apoptosis in lymphoid malignancies. This combination targets multiple pathways critical for the proliferation of malignant hematologic cells. While combinations of methotrexate, L-asparaginase, and dexamethasone are established in protocols for acute lymphoblastic leukemia (ALL) or NK/T-cell lymphoma[2][4][10], the addition of idarubicin suggests use in high-risk or relapsed/refractory settings where intensified regimens are needed. The regimen aims to maximize cytotoxicity through complementary mechanisms while managing resistance.

Other names

Ida/Metho/L-asp/DexIdarubicin + Methotrexate + L-asparaginase + Dexamethasone