methotrexate + 6-mercaptopurine + pegaspargase

Cycle 3 Early consolidation refers to a specific therapeutic phase within the GIMEMA LAL1913 clinical trial protocol (NCT02067156). This regimen is a pediatric-inspired, pegaspargase-containing treatment designed for adult patients with Philadelphia chromosome-negative (Ph-) acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma. The cycle consists of high-dose methotrexate (HD-MTX), 6-mercaptopurine (6-MP), and pegaspargase (Peg-ASP). Methotrexate acts as an antimetabolite by inhibiting dihydrofolate reductase and thymidylate synthase, thereby disrupting DNA synthesis. 6-mercaptopurine is a purine analogue that interferes with nucleic acid production. Pegaspargase is a pegylated form of the enzyme L-asparaginase, which depletes circulating L-asparagine, an amino acid essential for the survival of asparagine-synthetase-deficient leukemic blasts. This combination is intended to achieve or maintain a negative minimal residual disease (MRD) status following induction therapy.

Other names

Cycle 3 Early consolidationCycle3 Early consolidationCycle-3 Early consolidationCycle 3 Early consolidation-Gruppo Italiano Malattie EMatologiche dell'Adulto-acute lymphoblastic leukemia-lymphoblastic lymphomaHD-MTX + 6-MP + Peg-ASPHigh-dose methotrexate + 6-mercaptopurine + pegylated asparaginase