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Pixantrone + fludarabine + dexamethasone + rituximab is a four-drug combination regimen, commonly abbreviated as FPD-R, developed for the treatment of relapsed or refractory indolent non-Hodgkin lymphoma. Pixantrone is a novel aza-anthracenedione designed to reduce cardiotoxicity compared to related agents like mitoxantrone, and it inhibits topoisomerase II and alkylates DNA. Fludarabine is a purine nucleoside analog that induces DNA chain termination, dexamethasone is a synthetic glucocorticoid with anti-inflammatory and lympholytic properties, and rituximab is a monoclonal antibody targeting CD20 on B cells, mediating cell lysis.
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