L-asparaginase is particularly used in which type of Leukemia (AIIMS Nov 2014)
Treatment of ALL
Treatment of ALL is divided into 4 stages.
a. Induction (to attain remission)
b. CNS therapy (to prevent CNS spread)
c. Intensification (Consolidation)
d. Maintenance (Continuation.) therapy.
The total duration of treatment ranges between 2 snd 2% yeats.
a. Induction of remission
i. Induction therapy is used to attain remision, to eradicate the leukemic cells from bone mal'row.
ii. Drugs used are - Wncristine, Prednisolone, L - Asparginuse, Anthracycline
iii. Duration of therapy is 4-6 weeks.
b. CNS therapy
i. Most children with leukemia have subclinical CNS involvement at the time of diagnosis.
ii. Moreover, CNS acts as a sanctuary site where leukemic cells are protected from systemic chemotherapr because of blood brain barrier.
iii. So, treatment to keep leukemia cells from spreading to the CNS is often started with induction.
iv. Treatment include -+ Intrathecal methotrexate plus cranial radiution.
i. If the patient goes into remission, the next step is to intensify the therapy for a short period.
ii. Drugs used are - Methotrexate, L - Asparginase, Epipodophyllotoxin, Cyclophosphamide, Cytarabine
i. Atter consolidation, the patient is generally put on a maintenance therapy to maintain the remission state and prevent relapse.
ii. Drugs used are - 6-mercaptopurine, Methotrexate, Prednisolone, Wncristine
iii. Duration of maintenance therapy is2-2.5 years.