rituximab + cyclophosphamide + doxorubicin + vincristine + dexamethasone + methotrexate + cytarabine

A multi-agent chemoimmunotherapy regimen combining the anti-CD20 monoclonal antibody rituximab with the Hyper-CVAD chemotherapy backbone (hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone) alternating with high-dose methotrexate and cytarabine. It is used as an intensive front-line or salvage regimen for aggressive B‑cell malignancies such as mantle cell lymphoma and high-risk diffuse large B‑cell lymphoma. Mechanistically, rituximab targets CD20 on B cells to mediate complement- and cell-dependent cytotoxicity; cyclophosphamide is an alkylating agent causing DNA crosslinks; doxorubicin is an anthracycline topoisomerase II inhibitor causing DNA breaks; vincristine inhibits microtubule polymerization; dexamethasone is a glucocorticoid inducing lymphocyte apoptosis; methotrexate inhibits dihydrofolate reductase impairing nucleotide synthesis; and cytarabine is a nucleoside analog inhibiting DNA polymerase. The regimen alternates courses of R-Hyper-CVAD with courses of rituximab plus high-dose methotrexate and cytarabine across eight cycles per classic protocols.

Other names

rituximab plus Hyper-CVAD alternating with high-dose methotrexate and cytarabineR-Hyper-CVAD alternating with methotrexate and cytarabinerituximab + HyperCVAD alternating with high-dose cytarabine and methotrexate