daclizumab + tacrolimus + methotrexate + mycophenolate mofetil

Zenapax + tacrolimus + methotrexate + mycophenolate mofetil is an investigational four-drug immunosuppressive regimen evaluated for the prophylaxis of acute graft-versus-host disease (aGvHD) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), particularly those with thalassemia major receiving transplants from alternative donors. The regimen combines daclizumab (Zenapax), a humanized monoclonal antibody targeting the interleukin-2 receptor alpha chain (CD25), with a standard triple-drug prophylaxis backbone consisting of tacrolimus (a calcineurin inhibitor), methotrexate (a folate antagonist), and mycophenolate mofetil (an inosine monophosphate dehydrogenase inhibitor). By simultaneously targeting multiple pathways of T-cell activation, proliferation, and survival, this combination aims to synergistically suppress alloreactive donor T-cell responses and reduce the incidence of severe aGvHD without compromising graft-versus-leukemia effects or significantly increasing infectious complications.