melphalan + cyclophosphamide + dexamethasone

Melphalan + cyclophosphamide + dexamethasone is a combination regimen of three small-molecule drugs used primarily in the treatment of multiple myeloma and related plasma cell disorders. Melphalan and cyclophosphamide are both alkylating agents that work by cross-linking DNA, leading to inhibition of DNA replication and cell death, particularly in rapidly dividing malignant cells. Dexamethasone is a synthetic glucocorticoid corticosteroid with anti-inflammatory and immunosuppressive properties; it also induces apoptosis in certain hematologic malignancies. This combination may be used as part of induction therapy or for patients who are not candidates for autologous stem cell transplantation, as well as in relapsed or refractory settings. The regimen leverages the synergistic cytotoxic effects of alkylators with the pro-apoptotic action of corticosteroids.