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Cyclophosphamide + dexamethasone (often abbreviated as CD or CyDex) is a combination therapy comprising the nitrogen mustard alkylating agent cyclophosphamide and the potent synthetic glucocorticoid dexamethasone. This regimen is a cornerstone in the management of plasma cell dyscrasias, including multiple myeloma and AL amyloidosis, where it serves as both a standalone doublet and a backbone for triplet or quadruplet combinations with proteasome inhibitors (e.g., bortezomib, carfilzomib, ixazomib) or immunomodulatory drugs. Beyond oncology, the combination is administered as Dexamethasone-Cyclophosphamide Pulse (DCP) therapy for severe autoimmune and connective tissue disorders such as systemic lupus erythematosus (SLE), systemic sclerosis, and dermatomyositis. Cyclophosphamide exerts its effect by forming DNA cross-links that inhibit DNA replication and trigger apoptosis, while dexamethasone modulates gene expression via the glucocorticoid receptor to suppress inflammatory cytokines and induce lymphoid cell death.
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