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Fludarabine + thiotepa is a combination of two chemotherapeutic agents used primarily as part of conditioning regimens before allogeneic hematopoietic stem cell transplantation (allo-HSCT), especially in patients with hematological malignancies such as acute myeloid leukemia (AML). Fludarabine is a purine analog that inhibits DNA synthesis by interfering with DNA polymerase and ribonucleotide reductase, leading to cytotoxicity in rapidly dividing cells. Thiotepa is an alkylating agent that crosslinks DNA strands, resulting in inhibition of DNA replication and cell death. The combination leverages the immunosuppressive and myeloablative properties of both drugs to facilitate engraftment and reduce the risk of graft rejection or relapse[1][2]. This regimen may be used alone or with other agents (such as melphalan or treosulfan) depending on patient-specific factors.
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