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This multi-drug conditioning regimen was developed by the University of California, San Francisco (UCSF) for adults undergoing matched unrelated donor hematopoietic stem cell transplantation. The protocol utilizes a combination of chemotherapy agents, busulfan and fludarabine phosphate, as a preparative conditioning regimen to achieve marrow ablation and immunosuppression. Busulfan acts as a DNA alkylating agent, while fludarabine phosphate is a nucleoside analog that inhibits DNA synthesis. Following transplantation, tacrolimus (a calcineurin inhibitor) and methotrexate (a dihydrofolate reductase inhibitor) are administered as prophylaxis against graft-versus-host disease (GVHD). Granulocyte colony-stimulating factor (G-CSF) is included in the protocol to support stem cell mobilization and accelerate hematopoietic engraftment. The regimen is primarily evaluated for the treatment of various hematologic malignancies and disorders, including acute and chronic leukemias, myelodysplastic syndromes, and multiple myeloma.
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