busulfan + cyclophosphamide + busulfan + fludarabine

The combination of busulfan, cyclophosphamide, and fludarabine refers to the components of two distinct myeloablative conditioning (MAC) regimens—BuCy (busulfan and cyclophosphamide) and BuFlu (busulfan and fludarabine)—that were evaluated in a head-to-head Phase III clinical trial (NCT00774280). These regimens are used to prepare patients with leukemia or myelodysplastic syndrome (MDS) for allogeneic hematopoietic cell transplantation (alloHCT). Busulfan and cyclophosphamide are alkylating agents that cross-link DNA, while fludarabine is a purine analog antimetabolite that inhibits DNA synthesis. The trial, sponsored by the Japan Adult Leukemia Study Group (JALSG), concluded that the BuFlu regimen was associated with higher rates of graft failure and lower rates of complete donor chimerism compared to the standard BuCy regimen in young adults eligible for myeloablative conditioning.

Other names

busulfan plus cyclophosphamidebusulfan plus fludarabine