thiotepa + cyclophosphamide + cladribine + cytarabine

This is a combination chemotherapy regimen consisting of four agents—thiotepa, cyclophosphamide, cladribine, and cytarabine. Each component is a small molecule antineoplastic agent with distinct but complementary mechanisms of action: - **Thiotepa** is an alkylating agent that crosslinks DNA strands, leading to inhibition of DNA replication and cell death. It is used in conditioning regimens for hematopoietic stem cell transplantation (HSCT) and in the treatment of various malignancies[4][8]. - **Cyclophosphamide** is also an alkylating agent that interferes with DNA replication by forming cross-links between DNA strands. It has broad use in oncology as well as immunosuppression[6]. - **Cladribine** is a purine nucleoside analog that incorporates into DNA during replication, causing strand breaks and apoptosis. It primarily targets lymphoid cells and has been used in hematologic malignancies such as leukemia[7][10]. - **Cytarabine** (also known as Ara-C) is a pyrimidine nucleoside analog that inhibits DNA synthesis by incorporating into replicating DNA strands, leading to chain termination. It plays a central role in the treatment of acute myeloid leukemia (AML) and other leukemias[5][7]. This combination may be considered for high-intensity conditioning prior to autologous or allogeneic stem cell transplantation or for salvage therapy in aggressive hematologic malignancies such as acute myeloid leukemia or lymphoma where multi-agent regimens are required for maximal cytoreduction.

Other names

TCCA conditioning regimen