methotrexate + fludarabine

Methotrexate + fludarabine is a sequential chemotherapy regimen investigated by the German CLL Study Group (GCLLSG) for the treatment of T-cell large granular lymphocytic leukemia (T-LGL). The protocol utilizes methotrexate as a first-line agent, which functions as an antimetabolite by inhibiting dihydrofolate reductase (DHFR), thereby preventing the synthesis of thymidylate and purines necessary for DNA replication. For patients who are refractory to or relapse after methotrexate, fludarabine is administered as a second-line therapy. Fludarabine is a purine analog that, once phosphorylated, inhibits DNA polymerase, ribonucleotide reductase, and DNA primase, leading to the inhibition of DNA synthesis and induction of apoptosis in malignant T-cells.

Other names

MTX followed by fludarabineMethotrexate and Fludarabine in T-LGL Leukemia