rituximab + fludarabine + cyclophosphamide + mitoxantrone

R-FCM is a chemoimmunotherapy regimen comprised of four drugs: rituximab (a monoclonal CD20 antibody), fludarabine (a purine analog antimetabolite), cyclophosphamide (an alkylating agent), and mitoxantrone (an anthracenedione cytotoxic agent). This combination is designed to enhance the cytotoxicity against malignant B-cells, particularly in chronic lymphocytic leukemia (CLL). Rituximab targets CD20 on B-lymphocytes, mediating cell lysis by antibody-dependent cellular cytotoxicity and complement activation[1][3]. Fludarabine inhibits DNA synthesis by interfering with DNA polymerase and ribonucleotide reductase. Cyclophosphamide alkylates DNA, leading to cell death, and mitoxantrone intercalates into DNA, inhibiting topoisomerase II and causing double-strand breaks. The regimen has demonstrated high response rates and acceptable toxicity in untreated CLL patients, with notable rates of minimal residual disease-negative complete responses[1][3].

Other names

R-FCM