cyclophosphamide + vincristine + doxorubicin + dexamethasone + methotrexate + cytarabine + rituximab

**cyclophosphamide + vincristine + doxorubicin + dexamethasone + methotrexate + cytarabine + rituximab** (commonly known as the **R-hyper-CVAD** or **R-HCVAD/MA** regimen) is an intensive chemoimmunotherapy regimen used to treat aggressive B-cell hematological malignancies. The regimen consists of alternating courses of two main schedules: Part A (R-hyper-CVAD), which combines the anti-CD20 monoclonal antibody rituximab with hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone; and Part B (R-MA), which combines rituximab with high-dose methotrexate and cytarabine. Developed primarily at the MD Anderson Cancer Center, this regimen is designed to maximize tumor cell death by combining agents with non-overlapping toxicities and distinct mechanisms of action, including DNA alkylation, DNA intercalation, topoisomerase II inhibition, tubulin polymerization inhibition, glucocorticoid receptor agonism, dihydrofolate reductase inhibition, and DNA polymerase inhibition. It is widely utilized off-label as a highly effective frontline therapy for mantle cell lymphoma, Burkitt lymphoma, high-risk diffuse large B-cell lymphoma, and CD20-positive acute lymphoblastic leukemia.

Other names

R-HCVADR-HCVAD/MAR-HCVAD/R-MAR-hyper-CVADR-hyper-CVAD regimenR-hyper-CVAD/MTX-AraCR-hyper-CVAD/MTX-cytarabinemodified R-hyper-CVADrituximab + cyclophosphamide + vincristine + doxorubicin + dexamethasone + methotrexate + cytarabine