busulfan + melphalan + fludarabine + G-CSF

This is a myeloablative, chemotherapy-only conditioning regimen developed by Memorial Sloan Kettering Cancer Center (MSKCC) for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT), particularly T-cell depleted transplants. The regimen consists of the alkylating agents busulfan and melphalan, the purine analog fludarabine, and granulocyte colony-stimulating factor (G-CSF). It was designed to provide effective cytoreduction and immunosuppression to ensure donor cell engraftment while avoiding the toxicities associated with total body irradiation (TBI). The protocol is primarily utilized for high-risk hematologic malignancies, including various leukemias and myelodysplastic syndromes, aiming to maintain low rates of graft-versus-host disease (GvHD) through the combination of intensive chemotherapy and T-cell depletion of the graft.

Other names

Bu/Mel/Flu regimenMSKCC chemotherapy-only conditioning regimenBusulfan-Melphalan-Fludarabine-G-CSF protocol