R-HDAC, or R-HD-AraC ( (R)ituximab plus (H)igh (D)ose (A)ra-(C)) is a

chemotherapy regimen A chemotherapy regimen is a regimen for chemotherapy, defining the drugs to be used, their dosage, the frequency and duration of treatments, and other considerations. In modern oncology, many regimens combine several chemotherapy drugs in comb ...

that is used, alternating with

R-Maxi-CHOP CHOP is the acronym for a chemotherapy regimen used in the treatment of non-Hodgkin lymphoma. CHOP consists of: * Cyclophosphamide, an alkylating agent which damages DNA by binding to it and causing the formation of cross-links * (also called do ...

, as part of so-called "Nordic protocol" of treating

mantle cell lymphoma Mantle cell lymphoma (MCL) is a type of non-Hodgkin's lymphoma (NHL), comprising about 6% of NHL cases. There are only about 15,000 patients presently in the United States with mantle cell lymphoma. It is named for the mantle zone of the lymph ...

. It consists of

monoclonal Monoclonality refers to the state of a line of cells that have been derived from a single clonal origin. Thus "monoclonal cells" can be said to form a single clone. The term ''monoclonal'' comes from the Ancient Greek ''monos'', meaning "alone" o ...

antibody An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and Viral disease, viruses. The antibody recognizes a unique m ...

rituximab Rituximab, sold under the brand name Rituxan among others, is a monoclonal antibody medication used to treat certain autoimmune diseases and types of cancer. It is used for non-Hodgkin lymphoma, chronic lymphocytic leukemia (in non-geriatric p ...

and high-dose

antimetabolite An antimetabolite is a chemical that inhibits the use of a metabolite, which is another chemical that is part of normal metabolism. Such substances are often similar in structure to the metabolite that they interfere with, such as the antifolate ...

cytarabine Cytarabine, also known as cytosine arabinoside (ara-C), is a chemotherapy medication used to treat acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), chronic myelogenous leukemia (CML), and non-Hodgkin's lymphoma. It is given by i ...

. High-dose Ara-C (HDAC) without rituximab also has several other uses in oncohematology. For example, HDAC, alone or alternating with HD-MTX, is often used for

primary CNS lymphoma Primary central nervous system lymphoma (PCNSL), also termed primary diffuse large B-cell lymphoma of the central nervous system (DLBCL-CNS), is a primary intracranial tumor appearing mostly in patients with severe immunodeficiency (typically pat ...

and for treating CNS involvement in any

lymphoma Lymphoma is a group of blood and lymph tumors that develop from lymphocytes (a type of white blood cell). In current usage the name usually refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enl ...

s, and also for so-called "CNS prophylaxis" (prophylactic use in those forms of lymphoma which show no signs of CNS involvement at diagnosis but have high chance of CNS relapse or recurrence). HDAC is also used as a consolidation regimen in

acute myeloid leukemia Acute myeloid leukemia (AML) is a cancer of the myeloid line of blood cells, characterized by the rapid growth of abnormal cells that build up in the bone marrow and blood and interfere with haematopoiesis, normal blood cell production. Sympto ...

after initial 7+3 induction. HDAC also can be used as the primary induction therapy in AML, with higher than in 7+3 success (remission) rate, but it is more toxic and causes more treatment-related complications and treatment-related mortality than 7+3 when used as primary induction therapy.

Dosing regimen

References

{{reflist Chemotherapy regimens used in acute myeloid leukemia Chemotherapy regimens used in lymphoma