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For ALL, chemotherapy may be given into the fluid surrounding the brain and spinal cord. This is called intrathecal chemotherapy.
The drugs traditionally used in intrathecal chemotherapy are methotrexate and cytarabine. Many authors defend the combined use of methotrexate, cytarabine and glucocorticosteroids, which is called triple intrathecal therapy (TIT). One of the most commonly corticosteroids used in TIT chemotherapy is hydrocortisone.