thiotepa + carmustine + busulfan

This high-dose chemotherapy (HDT) conditioning regimen, consisting of the alkylating agents thiotepa, carmustine, and busulfan, is used as consolidation therapy for patients with newly diagnosed primary central nervous system lymphoma (PCNSL). Developed and studied by the University Hospital Freiburg as part of the MATRix phase III trial, the regimen is administered prior to autologous stem cell transplantation (ASCT). These specific agents were selected for their superior ability to penetrate the blood-brain barrier, which is essential for treating CNS malignancies. The drugs function as small molecule alkylators that form covalent bonds with DNA, leading to cross-linking and strand breaks that inhibit DNA replication and trigger apoptosis in lymphoma cells. In the clinical protocol, busulfan is often utilized as a substitute for carmustine if the latter is unavailable at the treatment site.

Brand names

CarmubrisBusilvex

Other names

BCNUthiotepa/carmustine/busulfan conditioning regimenMATRix trial conditioning regimen