methotrexate + asparaginase + vincristine

Capizzi maintenance (also known as the Capizzi regimen or Capizzi methotrexate) is a chemotherapy maintenance protocol primarily used in the treatment of pediatric and young adult acute lymphoblastic leukemia (ALL). The regimen is characterized by the administration of escalating doses of intravenous methotrexate without leucovorin rescue, followed approximately 24 hours later by L-asparaginase (often as Elspar or pegaspargase), and frequently includes vincristine. Methotrexate acts as a folate antimetabolite by inhibiting dihydrofolate reductase, thereby blocking DNA synthesis, while L-asparaginase depletes systemic asparagine, exploiting the inability of leukemic lymphoblasts to synthesize this essential amino acid. This protocol was a central component of the UKALL 2003 trial, led by the University of Oxford, which utilized minimal residual disease (MRD) response to optimize treatment intensity in children and young adults with ALL.

Other names

Capizzi maintenanceCapizzi methotrexateCapizzi regimenCapizzi MTX/ASNase