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This drug is a combination therapy consisting of azacitidine, chidamide, and mitoxantrone hydrochloride liposome. Azacitidine is a DNA methyltransferase inhibitor that induces hypomethylation of DNA, leading to reactivation of tumor suppressor genes and apoptosis in malignant cells. Chidamide is an oral histone deacetylase (HDAC) inhibitor targeting HDAC1, 2, 3, and 10; it modulates gene expression by altering chromatin structure and has demonstrated synergistic effects with DNA methyltransferase inhibitors in hematologic malignancies. Mitoxantrone hydrochloride liposome is a liposomal formulation of the anthracenedione antineoplastic agent mitoxantrone; it intercalates into DNA and inhibits topoisomerase II activity, resulting in cytotoxicity to rapidly dividing cells. The combination (sometimes referred to as the "MAC" regimen) has shown high response rates with manageable toxicity in clinical studies for relapsed/refractory T follicular helper cell lymphoma (TFHL) and other peripheral T-cell lymphomas[1][2][4]. This regimen leverages epigenetic modulation alongside cytotoxic chemotherapy.
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