fludarabine + mitoxantrone + cyclophosphamide + alemtuzumab

The combination of fludarabine, mitoxantrone, and cyclophosphamide followed by alemtuzumab—commonly referred to as the FMC-A regimen—is a sequential chemoimmunotherapy protocol primarily investigated for the treatment of T-cell prolymphocytic leukemia (T-PLL). Fludarabine is a purine analog that inhibits DNA synthesis by targeting DNA polymerase alpha, ribonucleotide reductase, and DNA primase. Mitoxantrone is an anthracenedione antineoplastic agent that intercalates into DNA and inhibits topoisomerase II alpha. Cyclophosphamide is an alkylating agent causing cross-linking of DNA strands. Alemtuzumab is a monoclonal antibody directed against CD52 on lymphocytes, leading to cell lysis via complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity. The regimen has demonstrated high response rates in phase 2 trials for T-cell prolymphocytic leukemia but carries significant risks of hematologic toxicity and infectious complications due to immunosuppression[1][2][3].

Brand names

Campath (for alemtuzumab)Fludara (for fludarabine)Novantrone (for mitoxantrone)Cytoxan (for cyclophosphamide)

Other names

FMC-A regimen