cyclophosphamide + valacyclovir

Cyclophosphamide + valacyclovir is a combination therapy consisting of cyclophosphamide, an alkylating agent used primarily as chemotherapy and immunosuppressant, and valacyclovir, an antiviral prodrug of acyclovir. Cyclophosphamide works by cross-linking DNA strands, leading to cell death in rapidly dividing cells such as cancer cells and certain immune cells. Valacyclovir inhibits viral DNA polymerase after conversion to acyclovir triphosphate within infected cells, thereby blocking replication of herpesviruses including Epstein-Barr virus (EBV) and varicella-zoster virus (VZV). This combination has been studied for safety in the treatment of EBV-associated Burkitt lymphoma in children and for prophylaxis against VZV reactivation in immunocompromised patients receiving cyclophosphamide-based regimens[1][6]. The rationale is to address both malignancy or autoimmune disease with cyclophosphamide while reducing the risk or burden of viral infections with valacyclovir.