idarubicin + etoposide + cytarabine + teniposide

This is a combination chemotherapy regimen consisting of four agents—idarubicin, etoposide, cytarabine, and teniposide—used primarily in the treatment of acute leukemias. - **Idarubicin** is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, leading to DNA strand breaks and inhibition of DNA replication. - **Etoposide** and **teniposide** are epipodophyllotoxin derivatives that also inhibit topoisomerase II, resulting in double-stranded DNA breaks. - **Cytarabine (Ara-C)** is a nucleoside analog that inhibits DNA synthesis by incorporation into DNA during the S-phase of the cell cycle. The combination leverages synergistic effects on leukemic cells by targeting multiple pathways involved in cell proliferation and survival[1][2][3][8]. This regimen or its close variants (often without teniposide) are used for induction therapy in acute myeloid leukemia (AML) or relapsed/refractory leukemia settings.