Intensification (consolidation) phase

After restoring normal haematopoiesis, intensification therapy is used to reduce the risk of a relapse by removing the drug-resistant residual leukaemic cells (1).

There is little consensus regarding the best regimens and duration of treatment.

• the following strategies are used frequently in childhood ALL:
  • high-dose methotrexate plus mercaptopurine,
  • reinduction treatment - use of the same drugs which was given initially
  • high-dose asparaginase for an extended period (2)
• for adults, a standard intensification regimen is absent but post remission therapy with cytarabine, cyclophosphamide, anthracyclines and methotrexate have been shown to be effective according to several non randomised trials

Reference:

• 1. Pui CH, Robison LL, Look AT. Acute lymphoblastic leukaemia. Lancet. 2008;371(9617):1030-43.
• 2. Pui CH, Evans WE. Treatment of acute lymphoblastic leukemia. N Engl J Med. 2006;354(2):166-78.