prednisone + dexamethasone + vincristine + daunorubicin

Prednisone + dexamethasone + vincristine + daunorubicin is a multi-agent chemotherapy combination used as part of the St. Jude Children's Research Hospital's Total Therapy Study XV (TOTXV) for newly diagnosed pediatric Acute Lymphoblastic Leukemia (ALL). This regimen consists of four active small molecule agents: prednisone and dexamethasone (glucocorticoids that induce apoptosis in leukemic lymphoblasts), vincristine (a vinca alkaloid that inhibits microtubule polymerization and disrupts mitotic spindle formation), and daunorubicin (an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II). These agents are typically administered during the remission induction phase of treatment. The TOTXV trial was a landmark Phase 3 study that prospectively used minimal residual disease (MRD) levels to guide risk-directed treatment and omitted prophylactic cranial irradiation.

Other names

TOTXV induction regimenTotal Therapy Study XV induction therapy