methotrexate + cytarabine + prednisolone

Intrathecal triple therapy is a standard-of-care combination chemotherapy regimen used for the prophylaxis and treatment of central nervous system (CNS) involvement in hematologic malignancies, particularly acute lymphoblastic leukemia (ALL). The regimen consists of three agents: methotrexate, an antimetabolite that inhibits dihydrofolate reductase; cytarabine (Ara-C), an antimetabolite that interferes with DNA synthesis by inhibiting DNA polymerase; and a corticosteroid, such as prednisolone or hydrocortisone, which provides anti-inflammatory effects and helps mitigate chemical arachnoiditis. By delivering these agents directly into the subarachnoid space via lumbar puncture, the therapy bypasses the blood-brain barrier to achieve therapeutic concentrations in the cerebrospinal fluid while minimizing systemic toxicity.

Other names

Intrathecal tripleIntrathecal triple therapyTITTriple intrathecal therapyIT triple