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This conditioning regimen, developed and investigated by the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, involves the addition of gemcitabine to a reduced-intensity backbone of busulfan and cyclophosphamide (BUCY2). It is designed for patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Gemcitabine, a pyrimidine antimetabolite, acts as a potent radiosensitizer and provides additional anti-leukemic activity by inhibiting ribonucleotide reductase and DNA polymerase. Busulfan and cyclophosphamide are alkylating agents that facilitate cytoreduction and immunosuppression. The combination aims to reduce relapse rates and improve survival outcomes in ALL patients by intensifying the conditioning regimen without prohibitive toxicity.
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