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TBI + fludarabine is a combination conditioning regimen used primarily before allogeneic hematopoietic cell transplantation (allo-HCT), especially in patients with acute lymphoblastic leukemia (ALL) and other hematologic malignancies. The regimen combines total body irradiation (TBI), which delivers ionizing radiation to the entire body to eradicate malignant cells and suppress the immune system, with fludarabine, a purine analog chemotherapeutic agent that inhibits DNA synthesis by interfering with DNA polymerase and ribonucleotide reductase. This combination can be used as either myeloablative or reduced-intensity conditioning depending on TBI dose and patient characteristics. The goal is to maximize disease eradication while minimizing toxicity prior to stem cell transplantation[1][3][4][5].
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