fludarabine + melphalan + anti-thymocyte globulin

This is a combination conditioning regimen used primarily before allogeneic hematopoietic cell transplantation (HCT), especially in patients with hematologic malignancies such as lymphoma and for unrelated or mismatched donor transplants. The regimen combines three agents: - **Fludarabine**: A purine analog that inhibits DNA synthesis by interfering with DNA polymerase and ribonucleotide reductase, leading to immunosuppression and cytotoxicity. - **Melphalan**: An alkylating agent that crosslinks DNA strands, inhibiting replication and transcription, resulting in cell death. - **Anti-thymocyte globulin (ATG)**: A polyclonal antibody preparation targeting human T lymphocytes, causing profound immunosuppression by depleting T cells. The combination is designed to provide effective disease control while reducing the risk of graft rejection and minimizing toxicity compared to more intensive regimens. ATG is particularly included for unrelated or mismatched donor HCTs to reduce the risk of graft-versus-host disease (GVHD) by depleting host immune cells[2][3].

Other names

FluMelATGFlu/Mel/ATGfludarabine/melphalan/antithymocyte globulin