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CR-CHOP + decitabine is a combination chemotherapy regimen used primarily in the treatment of diffuse large B-cell lymphoma (DLBCL), particularly in relapsed/refractory or high-risk cases. The regimen combines the standard CR-CHOP protocol—which includes cyclophosphamide (an alkylating agent), doxorubicin (a DNA intercalator and topoisomerase II inhibitor), vincristine (a microtubule inhibitor), prednisone or prednisolone (corticosteroids), and rituximab (an anti-CD20 monoclonal antibody)—with decitabine, a hypomethylating agent that inhibits DNA methyltransferase. Decitabine acts as an epigenetic modulator, reactivating silenced tumor suppressor genes and enhancing chemosensitivity. This combination aims to improve response rates by leveraging both cytotoxic and epigenetic mechanisms, with evidence suggesting potential synergy between these agents[2][3][6].
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