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This combination regimen is a modified myeloablative conditioning (MAC) protocol developed by Nanfang Hospital, Southern Medical University, for patients with high-risk myelodysplastic syndromes (MDS), such as RAEB-1 and RAEB-2, or secondary acute myeloid leukemia (sAML) undergoing allogeneic hematopoietic stem cell transplantation. The regimen integrates granulocyte colony-stimulating factor (G-CSF) and decitabine into the standard busulfan and cyclophosphamide (BUCY) framework. G-CSF is administered to mobilize and prime quiescent leukemia cells into the cell cycle, potentially enhancing their susceptibility to chemotherapy, while decitabine acts as a hypomethylating agent to induce epigenetic changes and further sensitize malignant cells. The primary goal of this intensified conditioning is to reduce the high incidence of post-transplant relapse in this patient population.
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