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This therapeutic regimen, developed by Ruijin Hospital (affiliated with Shanghai Jiao Tong University School of Medicine), is a combination therapy designed for elderly patients (aged 60-75 years) with acute myeloid leukemia (AML) who have achieved remission. The protocol utilizes a conditioning regimen consisting of low-dose decitabine, a DNA methyltransferase inhibitor that induces epigenetic modifications, and intermediate-dose cytarabine, a cytotoxic antimetabolite that inhibits DNA synthesis. Following this conditioning, patients receive an infusion of unrelated umbilical cord blood (UCB) units, which are HLA-mismatched (typically at least a 4/6 match). The biological rationale for this approach is to combine the direct anti-leukemic effects of chemotherapy with the potential immune-mediated graft-versus-leukemia (GVL) effect provided by the allogeneic cord blood cells, offering a consolidation strategy that aims to be more tolerable for older patients than standard high-dose chemotherapy or conventional hematopoietic stem cell transplantation.
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