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The combination of liposomal doxorubicin, etoposide, and methylprednisolone, commonly known as the DEP regimen, is a salvage chemotherapy protocol developed by researchers at Beijing Friendship Hospital and Capital Medical University for the treatment of refractory or relapsed hemophagocytic lymphohistiocytosis (HLH). HLH is a severe, life-threatening hyperinflammatory syndrome characterized by a cytokine storm and uncontrolled activation of T cells and macrophages. The regimen utilizes etoposide to inhibit topoisomerase II and induce apoptosis in activated T cells, liposomal doxorubicin to provide cytotoxic effects with reduced cardiotoxicity compared to conventional formulations, and methylprednisolone to provide potent anti-inflammatory and immunosuppressive effects via glucocorticoid receptor activation. Clinical trials have demonstrated that the DEP regimen is effective in achieving rapid control of the disease in patients who have failed standard induction therapies like the HLH-94 or HLH-2004 protocols.
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