mitoxantrone + cytarabine + granulocyte colony-stimulating factor

mitoxantrone + cytarabine + granulocyte colony-stimulating factor (often abbreviated as the MAG regimen) is a combination chemotherapy protocol primarily utilized in the treatment of pediatric hematologic malignancies, including childhood acute megakaryoblastic leukemia (AMKL). The regimen leverages the synergistic effects of mitoxantrone, an anthracenedione that intercalates DNA and inhibits topoisomerase II, and cytarabine, an antimetabolite that inhibits DNA polymerase and causes premature chain termination. The addition of granulocyte colony-stimulating factor (G-CSF) serves a dual purpose: it primes dormant leukemic blasts by inducing them into the S-phase of the cell cycle, thereby increasing their susceptibility to the cytotoxic agents, and it facilitates faster myeloid recovery to mitigate the duration of severe neutropenia. This specific combination has been studied by the Children's Hospital of Soochow University as an intensive induction or salvage therapy for high-risk pediatric leukemia patients.

Other names

MAG regimenMitoxantrone-Cytarabine-G-CSF