bleomycin + cyclophosphamide + mitoxantrone

**Bleomycin + cyclophosphamide + mitoxantrone** is a combination chemotherapy regimen consisting of three cytotoxic agents used primarily in the treatment of various lymphomas and sarcomas. Bleomycin is a glycopeptide antibiotic that causes DNA strand breaks via free radical formation, primarily affecting rapidly dividing cells with minimal myelosuppression. Cyclophosphamide, an alkylating agent prodrug, is activated to phosphoramide mustard, which crosslinks DNA strands inhibiting replication and transcription. Mitoxantrone, an anthracenedione antitumor antibiotic, intercalates DNA and inhibits topoisomerase II, leading to DNA damage and apoptosis. This triplet combination leverages non-overlapping toxicities to enhance antitumor efficacy while allowing dose intensification, historically explored in aggressive non-Hodgkin lymphomas and refractory solid tumors.