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Thiotepa + carmustine is a high-dose chemotherapy conditioning regimen being evaluated by the Washington University School of Medicine for the treatment of high-risk diffuse large B-cell lymphoma (DLBCL). This combination is utilized as a conditioning step prior to autologous stem cell transplant (ASCT) specifically to prevent secondary central nervous system (CNS) relapse in patients who have achieved their first complete remission. Both thiotepa and carmustine are alkylating agents characterized by their ability to effectively cross the blood-brain barrier, a property that distinguishes this regimen from the standard BEAM (carmustine, etoposide, cytarabine, and melphalan) protocol. By targeting potential subclinical CNS disease, the regimen aims to reduce the high mortality associated with secondary CNS recurrence in high-risk systemic DLBCL populations.
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