fludarabine + mitoxantrone + rituximab + yttrium-90 ibritumomab tiuxetan

The FM + R-University of Bologna-follicular lymphoma regimen is a sequential chemo-immunotherapy treatment strategy developed for patients with grade I-II follicular lymphoma. The protocol consists of an induction phase using the FMR regimen (fludarabine, mitoxantrone, and rituximab) followed by consolidation therapy with Zevalin (yttrium-90 ibritumomab tiuxetan). Fludarabine is a purine analog that inhibits DNA synthesis, while mitoxantrone is an anthracenedione that acts as a type II topoisomerase inhibitor and DNA intercalator. Rituximab is a chimeric monoclonal antibody targeting the CD20 antigen on B-cells. The consolidation agent, Zevalin, is a radioimmunotherapy consisting of a murine anti-CD20 antibody (ibritumomab) conjugated to the beta-emitting radioisotope yttrium-90 via the chelator tiuxetan. This multi-modal approach aims to achieve high complete response rates by combining traditional chemotherapy with targeted immunotherapy and localized radiation.

Brand names

RituxanZevalinNovantroneFludara

Other names

FM + RFMR regimenFMR plus ZevalinFM + R-University of Bologna-follicular lymphoma