thiotepa + etoposide + doxorubicin + dexamethasone + rituximab

This is a multi-agent chemotherapy and immunotherapy combination regimen consisting of five drugs: - **Thiotepa** (an alkylating agent) - **Etoposide** (a topoisomerase II inhibitor) - **Doxorubicin** (an anthracycline antibiotic, DNA intercalator and topoisomerase II inhibitor) - **Dexamethasone** (a synthetic glucocorticoid corticosteroid with anti-inflammatory and immunosuppressive effects) - **Rituximab** (a chimeric monoclonal antibody targeting CD20 on B lymphocytes) This combination is not a standard named regimen but represents an intensive protocol that combines cytotoxic chemotherapy with targeted immunotherapy. Each component has a distinct mechanism of action, contributing to the overall antineoplastic effect. Such combinations are typically used in the treatment of aggressive hematological malignancies, such as certain types of lymphoma or leukemia, especially in high-risk or relapsed/refractory settings where both CNS penetration and systemic disease control are required[2][4][6][7]. Rituximab specifically targets CD20-positive B cells for immune-mediated destruction[6][8], while the chemotherapeutic agents induce cell death through DNA damage or inhibition of cell division.