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COP + CYM is a multi-agent combination chemotherapy regimen developed by St. Jude Children's Research Hospital for the treatment of pediatric and young adult patients with aggressive mature B-cell malignancies. This regimen is a core component of the SJBC3 (Mature B-Cell Lymphoma and Leukemia Study III) protocol, which utilizes a risk-adapted approach to therapy. The COP phase consists of cyclophosphamide (an alkylating agent), vincristine (a microtubule inhibitor), and prednisone (a corticosteroid). The CYM phase consists of cytarabine (an antimetabolite) and methotrexate (a folate antagonist). These agents work synergistically to target rapidly dividing cancer cells by inducing DNA damage, inhibiting mitosis, and disrupting essential metabolic pathways for DNA synthesis. The regimen is primarily indicated for Burkitt lymphoma, diffuse large B-cell lymphoma (DLBCL), mediastinal large B-cell lymphoma, and B-cell acute lymphoblastic leukemia (B-ALL).
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