CLAGE + FluBu

CLAGE-FluBu is an intensive sequential conditioning regimen designed for patients with refractory acute leukemia, including acute myeloid leukemia (AML) and chronic myeloid leukemia in blastic crisis (CML-BC), who are undergoing allogeneic stem cell transplantation. Developed by the Shanghai Jiao Tong University School of Medicine, the regimen combines the CLAGE protocol (cladribine, intermediate-dose cytarabine, G-CSF, and etoposide) with a subsequent FluBu phase (fludarabine and busulfan). This multi-agent approach utilizes various mechanisms to achieve potent anti-leukemic debulking: cladribine, cytarabine, and fludarabine act as nucleoside analogs to inhibit DNA synthesis; etoposide inhibits topoisomerase II; busulfan serves as a DNA alkylating agent; and G-CSF is included to sensitize quiescent leukemic cells to the cytotoxic effects of the chemotherapy. The regimen is typically followed by post-transplant maintenance therapy, such as low-dose decitabine, to further mitigate the risk of relapse.

Other names

CLAGE-FluBu regimenCladribine + Cytarabine + G-CSF + Etoposide + Fludarabine + Busulfan