mitoxantrone + etoposide + dexamethasone + cytarabine + methylprednisolone

A multi-agent chemotherapy combination containing **mitoxantrone**, **etoposide**, **dexamethasone**, **cytarabine**, and **methylprednisolone**. Each component has a distinct mechanism of action and collectively they are used for the treatment of hematological malignancies, especially in the salvage therapy of relapsed or refractory acute myeloid leukemia (AML) and aggressive non-Hodgkin lymphoma (NHL). - **Mitoxantrone** is an anthracenedione antibiotic, intercalating into DNA and inhibiting topoisomerase II, leading to DNA breaks and apoptosis. - **Etoposide** is a topoisomerase II inhibitor, causing DNA strand breaks and cell death. - **Dexamethasone** and **methylprednisolone** are synthetic glucocorticoids that bind to the glucocorticoid receptor and induce apoptosis in sensitive lymphoid cells. - **Cytarabine** is a pyrimidine analog that inhibits DNA synthesis by incorporation into DNA and inhibiting DNA polymerase. This combination, sometimes referred to as "MEC" (mitoxantrone + etoposide + cytarabine) with added steroids, is used in various protocols for relapsed/refractory AML and aggressive lymphomas[5][6][8][7].