Flu-Bu-Mel-E

Flu-Bu-Mel-E is a code name for a combination conditioning regimen consisting of Fludarabine, Busulfan, Melphalan, and Etoposide. This regimen is utilized in allogeneic hematopoietic stem cell transplantation (allo-HSCT), primarily for patients with lymphoid and myeloid malignancies. The drugs in this combination are cytotoxic agents designed to suppress the patient's immune system and eradicate malignant cells, thereby preparing the bone marrow for the engraftment of donor stem cells. Fludarabine acts as a purine analogue, inhibiting nucleic acid synthesis. Busulfan and Melphalan are alkylating agents that damage DNA, while Etoposide is a topoisomerase II inhibitor, interfering with DNA replication and repair. This regimen aims to achieve myeloablation while managing toxicity. A Phase II clinical trial (NCT04897139) sponsored by Shanghai Jiao Tong University School of Medicine is evaluating its efficacy and feasibility in patients with lymphoid malignancies.