Acute lymphoblastic leukaemia (ALL) — UKMLA MCQ
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Correct answer: C — Combination chemotherapy such as vincristine steroid asparaginase
The correct answer is C. In a 10-year-old with newly diagnosed acute lymphoblastic leukaemia, the standard mainstay is risk-adapted multi-agent systemic chemotherapy. NICE recommends pegaspargase as part of antineoplastic combination therapy for untreated newly diagnosed ALL; typical induction regimens include vincristine, a corticosteroid such as dexamethasone or prednisolone, and asparaginase/pegaspargase, with additional agents and CNS prophylaxis depending on risk group. High-dose methotrexate may be used within later treatment phases but is not used alone. Corticosteroids alone, spinal radiotherapy, and palliative care alone are not appropriate mainstay treatments for a child with newly diagnosed ALL.
Reference: NICE Technology Appraisal Guidance TA408: Pegaspargase for treating acute lymphoblastic leukaemia (2016; current NICE guidance). https://www.nice.org.uk/guidance/ta408