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decitabine + thiotepa + busulfan + fludarabine + antithymocyte globulin (DTBFA) is a novel myeloablative conditioning regimen developed for patients with myelofibrosis undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT). The regimen combines the hypomethylating agent decitabine, the alkylating agents thiotepa and busulfan, the purine analog fludarabine, and the immunosuppressant antithymocyte globulin (ATG). This combination is designed to optimize graft function, enhance myelofibrosis regression, and reduce graft failure and non-relapse mortality by tailoring the conditioning intensity based on pre-transplant spleen size.
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