Pixantrone is a next generation antitumor aza-anthracenedione with molecular structure similar to other topoisomerase II inhibitors, such as anthracyclines, but is modified to improve efficacy and reduced toxicity. Unfortunately, in this days FDA postpone the acceptance of this drug in the treatment of patients with relapsed or refractory aggressive non-Hodgkin's lymphoma who received two or more prior lines of therapy. Clinical trials prove safety and effectiveness of therapy using pixantron dimaleate, without cumulative heart damage causes by anthracyclines such as doxorubicin.