Used primarily in chemotherapy, this compound is effective in treating certain types of cancer, including chronic lymphocytic leukemia (CLL) and indolent non-Hodgkin’s lymphoma (NHL). It functions by interfering with DNA replication and transcription through alkylation and cross-linking of DNA strands, ultimately leading to cancer cell death. Its unique dual mechanism—combining alkylating properties with antimetabolite-like activity—makes it particularly useful in patients who have relapsed or are refractory to other treatments. The esterification with D-mannitol improves solubility and stability, allowing for more efficient intravenous delivery and consistent pharmacokinetics. It is often preferred in regimens where prolonged response and manageable side effects are critical.