Teniposideis a chemotherapeutic medication mainly used in the treatment of childhood acute lymphocytic leukemia (ALL). It is in a class of drugs known as podophyllotoxin derivatives and slows the growth of cancer cells in the body. Teniposide causes dose-dependent single- and double-stranded breaks in DNA and DNA-protein cross-links. The mechanism of action appears to be related to the inhibition of type II topoisomerase activity since teniposide does not intercalate into DNA or bind strongly to DNA. The cytotoxic effects of teniposide are related to the relative number of double-stranded DNA breaks produced in cells, which are a reflection of the stabilization of a topoisomerase II-DNA intermediate. The medication is injected though a vein and burns if it leaks under the skin. It is sometimes used in combination with other anticancer drugs.