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A multi-agent chemotherapy regimen combining seven drugs with complementary mechanisms used in hematologic malignancies. It includes the alkylating agent cyclophosphamide, the microtubule inhibitor vincristine, the anthracycline topoisomerase II inhibitor doxorubicin, the glucocorticoid dexamethasone, the long-acting asparagine-depleting enzyme pegaspargase, and the antimetabolites methotrexate and cytarabine. Together, these agents target DNA synthesis and repair, mitosis, amino acid availability, and lymphoid proliferation. Such combinations are used in acute lymphoblastic leukemia and certain lymphomas; exact dosing, scheduling, and CNS-directed administration (e.g., intrathecal methotrexate or cytarabine) vary by protocol.
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