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Clofarabine + busulfan + melphalan (CloB2M) is a myeloablative conditioning regimen composed of three small-molecule chemotherapeutic agents used prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT). It is primarily investigated for adult patients with acute myeloid leukemia (AML) in first complete remission (CR1). The regimen combines clofarabine, a purine nucleoside analogue that inhibits ribonucleotide reductase and DNA polymerase, with two alkylating agents, busulfan and melphalan, which act by cross-linking DNA strands. This combination is designed to provide potent anti-leukemic activity and facilitate successful engraftment in the transplant setting, serving as an alternative to other conditioning backbones such as fludarabine + busulfan-based regimens.
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