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Rituximab + vincristine + cyclophosphamide + methotrexate + doxorubicin + cytarabine + cytarabine (also known as Rituximab + LMB chemotherapy) is a combination chemoimmunotherapy regimen evaluated for the treatment of high-risk pediatric B-cell malignancies. The regimen integrates the anti-CD20 monoclonal antibody rituximab with the intensive LMB (Lymphome Malin B) chemotherapy backbone. The LMB backbone consists of vincristine, cyclophosphamide, high-dose methotrexate, doxorubicin, and cytarabine, typically administered in distinct induction (COPADM) and consolidation (CYM, CYVE) courses, often supplemented with corticosteroids and intrathecal therapy. Rituximab targets the CD20 antigen expressed on the surface of B-cells, facilitating immune-mediated cell death, while the chemotherapy components provide broad cytotoxic activity through DNA alkylation, microtubule inhibition, and antimetabolite mechanisms. This combination was notably studied in the global Phase 3 Inter-B-NHL Ritux 2010 trial, demonstrating improved event-free survival in children and adolescents with advanced-stage B-cell non-Hodgkin lymphoma and B-cell acute leukemia.
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