fludarabine + melphalan + thiotepa

The combination of **fludarabine, melphalan, and thiotepa** is used as a conditioning regimen prior to **allogeneic hematopoietic stem cell transplantation** (allo-HCT), particularly for patients with advanced hematologic malignancies who may not tolerate more intensive regimens. This combination is considered a reduced-intensity or reduced-toxicity protocol designed to provide adequate **immunosuppression** and antineoplastic activity for successful engraftment of donor cells. - **Fludarabine** is a purine analog that inhibits DNA synthesis by interfering with DNA polymerase, ribonucleotide reductase, and DNA primase, primarily used for its cytotoxic and immunosuppressive properties. - **Melphalan** is an alkylating agent that crosslinks DNA and RNA, interfering with replication and transcription, contributing further to antitumor effects and immunosuppression. - **Thiotepa** is also an alkylating agent that adds additional immunosuppressive and cytotoxic effects and may improve engraftment rates when added to fludarabine and melphalan[1][2][3]. This regimen is primarily indicated for patients undergoing allogeneic transplantation using alternative donors, such as unrelated cord blood or haploidentical donors, and is being studied for safety and efficacy in these populations[1][2][3].

Other names

FMTFTM