lomustine + bleomycin + vincristine + cyclophosphamide

**Lomustine + bleomycin + vincristine + cyclophosphamide** is a chemotherapy combination regimen primarily used for treating malignancies such as malignant thymoma and Hodgkin's disease. It integrates lomustine (a nitrosourea alkylating agent that cross-links DNA at the O6 position of guanine), bleomycin (which induces DNA strand breaks via free radical formation), vincristine (a vinca alkaloid that inhibits microtubule assembly and mitosis), and cyclophosphamide (an alkylating agent that forms DNA cross-links after metabolic activation). This multi-agent approach targets rapidly dividing cancer cells through complementary mechanisms, enhancing efficacy in refractory or relapsed cases, though it carries risks of myelosuppression, pulmonary toxicity, and secondary malignancies.