L–asparaginase is particularly used in which type of leukemia –

Treatment of ALL Treatment of ALL is divided into 4 stages. Induction (to attain remission) CNS therapy (to prevent CNS spread) Intensification (Consolidation) Maintenance (Continuation) therapy The total duration oLtreatment ranges between 2 and 21/2 years. 1. Induction of remission Induction therapy is used to attain remission, i.e., to eradicate the leukemic cells from bone marrow. Drugs used are Vincristine, Prednisolone, L Asparginase, Anthracycline Duration of therapy is 4-6 weeks. 2. CNS therapy Most children with leukemia have subclinical CNS involvement at the time of diagnosis. Moreover, CNS acts as a sanctuary site where leukemic cells are protected from systemic chemotherapy because of blood brain barrier. So, treatment to keep leukemia cells from spreading to the CNS is often started with induction. Treatment include → Intrathecal methotrexate plus cranial radiation. 3. Intensification If the patient goes into remission, the next step is to intensify the therapy for a short period. Drugs used are → Methotrexate, L - Asparginase, Epipodophyllotoxin, Cyclophosphamide, Cytarabine 4. Maintenance therapy After consolidation, the patient is generally put on a maintenance therapy to maintained the remission state and prevent relapse. Drugs used are → 6-mercaptopurine, Methotrexate, Prednisolone, Vincristine Duration of maintenance therapy is 2-2.5 years.