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Pentostatin + cyclophosphamide + rituximab is a combination chemoimmunotherapy regimen used primarily for the treatment of indolent B-cell lymphomas, including chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), follicular lymphoma (FL), marginal zone lymphoma (MZL), and other low-grade B-cell neoplasms. Pentostatin is a purine nucleoside analog that inhibits adenosine deaminase, leading to impaired DNA synthesis and apoptosis in lymphocytes. Cyclophosphamide is an alkylating agent that crosslinks DNA, resulting in cell death. Rituximab is a chimeric monoclonal antibody targeting CD20 on B cells, leading to their depletion via immune-mediated mechanisms. The combination leverages the cytotoxic effects of chemotherapy with targeted immunotherapy to achieve high response rates and durable remissions in both previously untreated and relapsed/refractory patients with indolent B-cell malignancies[1][2][3][4][8][9].
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