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This is a combination chemotherapy regimen consisting of fludarabine, a purine analog antimetabolite, and pegylated liposomal doxorubicin, an anthracycline antibiotic formulated in long-circulating PEG-coated liposomes. Fludarabine inhibits DNA synthesis by interfering with DNA polymerase alpha, ribonucleotide reductase, and DNA primase activities, leading to inhibition of cancer cell proliferation[3][4]. Pegylated liposomal doxorubicin intercalates into DNA and inhibits topoisomerase II activity, resulting in cytotoxicity through the generation of free radicals and induction of apoptosis. The pegylation extends circulation time and alters tissue distribution compared to conventional doxorubicin. This combination is primarily investigated for hematologic malignancies such as chronic lymphocytic leukemia (CLL), leveraging the synergistic cytotoxic effects on malignant lymphocytes[1].
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