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R-mNHL-BFM-90 is a modified, rituximab-containing version of the NHL-BFM-90 chemotherapy protocol. It is used primarily for the treatment of high-risk, de novo diffuse large B-cell lymphoma (DLBCL) in adults and has its origins in pediatric aggressive B-cell lymphoma regimens. The regimen combines short-pulse, multi-agent chemotherapy with rituximab, an anti-CD20 monoclonal antibody. The backbone includes agents such as cyclophosphamide, vincristine, ifosfamide, etoposide, doxorubicin (adriamycin), methotrexate, vindesine, dexamethasone, and cytarabine[5][6]. Rituximab targets CD20 on B-cells to induce cell lysis via immune-mediated mechanisms; the chemotherapeutic agents act through various cytotoxic mechanisms including DNA damage and inhibition of mitosis. This protocol was adapted from pediatric protocols for use in adults under 60 years with high-risk DLBCL and has demonstrated high efficacy with acceptable toxicity profiles[6].
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