anti-thymocyte globulin + busulfan + fludarabine

This is a combination conditioning regimen used primarily before allogeneic hematopoietic cell transplantation (HCT), especially in patients with acute myeloid leukemia (AML) and other hematologic malignancies. The regimen consists of: - **Anti-thymocyte globulin (ATG):** A polyclonal antibody preparation that targets human T cells, leading to profound immunosuppression by depleting T lymphocytes. This reduces the risk of graft-versus-host disease (GVHD) and facilitates engraftment. - **Busulfan:** An alkylating agent that crosslinks DNA, resulting in cytotoxicity to both malignant and normal hematopoietic cells. It provides myeloablation and immunosuppression. - **Fludarabine:** A purine analog that inhibits DNA synthesis by interfering with ribonucleotide reductase and DNA polymerase activity, providing both immunosuppressive effects for engraftment and direct antitumor activity. This combination is widely used as a reduced-intensity conditioning (RIC) protocol for patients who may not tolerate fully myeloablative regimens due to age or comorbidities. The addition of ATG has been shown to reduce the incidence of chronic GVHD without compromising leukemia control[1][2][3].

Brand names

BusilvexThymoglobuline

Other names

ATG + busulfan + fludarabineantithymocyte globulin + busulfan + fludarabine