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Busulfan + melphalan + thiotepa is a combination chemotherapy regimen consisting of three alkylating agents—busulfan, melphalan, and thiotepa. This regimen is primarily used as a high-dose conditioning treatment before autologous or allogeneic stem cell transplantation in patients with aggressive hematologic malignancies such as non-Hodgkin's lymphoma, Hodgkin's disease, acute leukemias, and central nervous system lymphomas. The combination works by cross-linking DNA strands and inhibiting DNA replication and transcription, leading to cell death in rapidly dividing cancer cells. It is often chosen for patients who have previously received radiotherapy that precludes the use of total body irradiation-based regimens[2][3][4][6].
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