Chemotherapy to Treat Acute Lymphocytic Leukemia (ALL)

Chemotherapy for ALL usually begins with a three-drug schedule such as:

Option 1: Chemotherapy with prednisone, vincristine sulfate (Oncovin), and an anthracycline drug (e.g., daunorubicin)

  • How is it given: Prednisone is given orally in three divided doses, and Vincristine is given intravenously (IV), the drug is delivered into the veins.
  • What is the duration: Prednisone and vincristine are given at weekly intervals for 4 weeks
  • What are the side effects: Vincristine - hair loss, nervous system effects

Option 2: Chemotherapy with prednisone. vincristine (Oncovin), and L-asparaginase (Elspar) or cyclophosphamide (Neosar)

  • How is it given:
    • Prednisone: orally
    • Vincristine: Intravenously (IV), the drug is delivered into the veins
    • L-asparaginase: IV or intramuscularly; subcutaneously, injected under the skin; or IV (least favorable due to allergic reactions with this route)
    • Cyclophosphamide: IV or orally
  • What is the duration: Prednisone and vincristine are given at weekly intervals for 4 weeks; the schedule for L-asparaginase is more variable. Cyclophosphamide is given every 2 to 5 days, or by another schedule.
  • What are the side effects:
    • Prednisone - immune system effects
    • Vincristine - hair loss, nervous system effects
    • L-asparaginase - anaphylactic (severe allergic) reactions, pancreas inflammation, blood clotting problems
    • Cyclophosphamide - infertility, severe bladder inflammation, cardiotoxicity (heart damage), immune system suppression, hair loss

Consolidation therapy for ALL (1-3 months in adults; 4-8 months in children) may involve treatment with combination chemotherapy or antimetabolites such as methotrexate and 6-mercaptopurine (6-MP):

Option 1: Chemotherapy with prednisone, vincristine (Oncovin), L-asparaginase (Elspar) and daunorubicin, followed by Cyclophosphamide (Neosar), cytarabine (ara-C; Cytosar-U), and 6-thioguanine (Tabloid)

Option 2: Chemotherapy with methotrexate sodium plus 6-mercaptopurine (6-MP; Purinethol)

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 14 Aug 1999

Last Modified: 24 Sep 2015