CODOX-M

CODOX-M is a dose-intensive, compact chemotherapy regimen used primarily for treating Burkitt lymphoma and other high-grade B-cell lymphomas. The name CODOX-M is an acronym representing the drugs in the regimen: **Cyclophosphamide**, Vincristine (**Oncovin**), **DOXorubicin**, and **Methotrexate**, with additional components including **Cytarabine** (given intrathecally) and **Leucovorin** (folinic acid) rescue after high-dose methotrexate. This regimen was originally described by Magrath et al. in 1996 and was designed to provide dose-intensive, non-cross-resistant therapy with effective central nervous system (CNS) targeting. The protocol was later refined in the LY10 trial, where methotrexate was dose-modified to 3 g/m² (from the original 6.7 g/m²) to reduce toxicity while maintaining efficacy. CODOX-M is often alternated with another regimen called IVAC (Ifosfamide, etoposide, high-dose Cytarabine) in high-risk patients, forming the complete Magrath protocol (CODOX-M/IVAC). For low-risk patients, three cycles of CODOX-M alone may be sufficient. The regimen includes intrathecal therapy (medications injected directly into the cerebrospinal fluid) to target or prevent CNS involvement. **Rituximab** is frequently added to the regimen (creating R-CODOX-M) to improve outcomes in CD20-positive B-cell lymphomas.

Other names

Cyclophosphamide-Vincristine-Doxorubicin-Methotrexate-Leucovorin