Pixantrone is primarily used in the treatment of relapsed or refractory aggressive non-Hodgkin lymphoma (NHL). It is administered intravenously and works by inhibiting topoisomerase II, an enzyme critical for DNA replication and cell division, thereby preventing the proliferation of cancer cells. Its unique structure reduces the risk of cardiotoxicity compared to other anthracyclines, making it a safer option for patients with pre-existing heart conditions. Pixantrone is often considered when other treatments have failed, offering a therapeutic alternative for patients with limited options. It is typically used in combination with other chemotherapeutic agents to enhance its efficacy. Clinical studies have shown improved response rates and progression-free survival in patients receiving pixantrone-based regimens.