methotrexate + pegaspargase

Capizzi maintenance is a chemotherapy regimen primarily used as an interim maintenance phase in the treatment of pediatric and young adult acute lymphoblastic leukemia (ALL). Developed and optimized within the University of Oxford-sponsored UKALL 2003 trial, the regimen consists of escalating doses of intravenous methotrexate administered without leucovorin rescue, combined with pegaspargase (pegylated L-asparaginase). Methotrexate acts as an antimetabolite by inhibiting dihydrofolate reductase, thereby disrupting DNA synthesis, while pegaspargase is an enzyme that depletes systemic L-asparagine, an amino acid essential for leukemia cell survival. This combination is designed to intensify treatment for patients with higher-risk disease or suboptimal minimal residual disease (MRD) response.

Other names

Capizzi maintenanceCapizzi regimenCapizzi maintenance-University of Oxford-acute lymphoblastic leukemiaescalating-dose methotrexate plus pegaspargase