muromonab-CD3 + fludarabine + thiotepa + melphalan + rituximab + mycophenolate mofetil

This multi-agent therapeutic regimen is a non-total body irradiation (TBI) based reduced-intensity conditioning (RIC) protocol developed by **St. Jude Children's Research Hospital**. It is specifically designed for pediatric patients with refractory hematological malignancies undergoing haploidentical stem cell transplantation. The regimen combines cytotoxic chemotherapy (fludarabine, thiotepa, and melphalan) to achieve myelosuppression and host immunosuppression with targeted monoclonal antibodies. **Muromonab-CD3 (OKT-3)** is utilized for T-cell depletion to reduce the risk of graft-versus-host disease (GVHD), while **rituximab** is administered to prevent post-transplant lymphoproliferative disorder (PTLPD). **Mycophenolate mofetil** is included as a pharmacological prophylaxis against GVHD. This protocol is typically used in conjunction with ex vivo T-cell depletion of the donor graft using the CliniMACS system to balance the risks of GVHD and infection while maintaining a graft-versus-malignancy effect.

Brand names

Orthoclone OKT3FludaraTepadinaAlkeranRituxanCellCept

Other names

Systemic chemotherapy and antibodiesSt. Jude Haploidentical SCT Conditioning RegimenOKT-3 + Fludarabine + Thiotepa + Melphalan + Rituximab + Mycophenolate mofetil