rituximab + etoposide + cytarabine + cisplatin

Rituximab + etoposide + cytarabine + cisplatin is an immunochemotherapy combination most commonly used as the rituximab-containing variant of the ESHAP or R-ESHAP salvage regimen for aggressive B‑cell lymphomas, including relapsed or refractory diffuse large B‑cell lymphoma. In this regimen, rituximab is a chimeric monoclonal antibody targeting the CD20 antigen on B lymphocytes, inducing complement-dependent cytotoxicity, antibody‑dependent cellular cytotoxicity, and direct apoptosis of malignant B cells. Etoposide is a topoisomerase II inhibitor that stabilizes the cleavable complex between topoisomerase II and DNA, leading to DNA strand breaks and apoptosis in rapidly dividing cells. Cytarabine is an antimetabolite (pyrimidine analog) that is phosphorylated intracellularly and incorporated into DNA, inhibiting DNA polymerase and DNA synthesis and triggering cell death, particularly in S-phase cells. Cisplatin is a platinum-based DNA crosslinking agent that forms intra- and interstrand DNA crosslinks, disrupting DNA replication and transcription and inducing apoptosis. Together, these agents provide synergistic cytotoxicity against rapidly dividing CD20-positive lymphoma cells and are typically administered intravenously in multi‑day cycles, often as salvage therapy or as part of regimens preceding autologous stem cell transplantation.[1][3][4][5][7][8][11]

Other names

R-ESHAP