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mBU + CY + ATG is a multi-drug myeloablative conditioning regimen used in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with relapsed or refractory acute leukemia, particularly in the context of HLA-mismatched transplants. Developed and investigated by Peking University People's Hospital, the regimen consists of modified busulfan (mBU), cyclophosphamide (CY), cytarabine (Ara-C), semustine (Me-CCNU), and anti-thymocyte globulin (ATG). The protocol is designed to maximize anti-leukemic activity through the synergistic effects of multiple alkylating agents and DNA synthesis inhibitors, while ATG provides essential T-cell depletion to mitigate the risk of graft-versus-host disease (GVHD). This regimen is frequently studied in combination with decitabine to further enhance its efficacy in high-risk leukemia populations.
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