mitoxantrone + cyclophosphamide + fludarabine + rituximab + GM-CSF

This regimen is a multi-agent chemoimmunotherapy combination used primarily in the treatment of chronic lymphocytic leukemia (CLL). It combines four drugs—mitoxantrone (a topoisomerase II inhibitor), cyclophosphamide (an alkylating agent), fludarabine (a purine analog antimetabolite), and rituximab (a monoclonal antibody targeting CD20)—with granulocyte-macrophage colony-stimulating factor (GM-CSF, a cytokine that stimulates white blood cell production). The addition of rituximab to the chemotherapy backbone has been shown to significantly improve response rates in CLL. GM-CSF is included to support hematopoiesis and reduce infection risk during myelosuppressive therapy. This combination has demonstrated high overall and complete response rates, including minimal residual disease-negative responses, with acceptable toxicity profiles in clinical trials for previously untreated CLL[1][2][3][4].

Other names

granulocyte-macrophage colony-stimulating factor