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Microtransplantation + decitabine + cytarabine is a combination chemo-immunotherapy regimen being evaluated for the treatment of myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). The regimen consists of the hypomethylating agent decitabine and the antimetabolite cytarabine, followed by microtransplantation—the infusion of HLA-mismatched, G-CSF-mobilized donor peripheral blood stem cells (G-PBSC). This approach, developed by the Affiliated Hospital of the Chinese Academy of Military Medical Sciences, is designed to harness a graft-versus-leukemia (GVL) effect from the donor cells and promote rapid hematopoietic recovery after chemotherapy. Unlike conventional allogeneic stem cell transplantation, microtransplantation does not require myeloablative conditioning or post-infusion immunosuppression, significantly reducing the risk of graft-versus-host disease (GVHD) and making it a viable option for older or less fit patients.
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