carboplatin + cotrimoxazole + cyclophosphamide + cytarabine + dexamethasone + doxorubicin + etoposide + ifosfamide + methotrexate + prednisone + vinblastine + vincristine

This intensive multi-agent chemotherapy regimen was developed by St. Jude Children's Research Hospital for the treatment of pediatric large cell lymphoma, specifically evaluated in their Pilot Study III. The protocol utilizes a broad spectrum of cytotoxic mechanisms to overcome resistance and improve outcomes in children with advanced-stage disease. It includes alkylating agents (cyclophosphamide, ifosfamide), antimetabolites (methotrexate, cytarabine), anthracyclines (doxorubicin), vinca alkaloids (vincristine, vinblastine), platinum-based agents (carboplatin), and topoisomerase inhibitors (etoposide). These are administered alongside corticosteroids (prednisone, dexamethasone) for their direct lympholytic effects and cotrimoxazole for mandatory prophylaxis against opportunistic infections like Pneumocystis jirovecii pneumonia (PJP). The regimen is characterized by a shorter, more intensive, immunophenotype-directed approach and is often followed by an intensification phase involving high-dose chemotherapy and hematopoietic stem cell support.

Other names

St. Jude Pilot Study III RegimenSt. Jude Children's Research Hospital Large Cell Lymphoma Protocol