Conditioning regimen comparison: FluBu vs FluBu+TBI in myeloid malignancies

Current understanding

To be populated as evidence accumulates.

Evidence log

• 2026-05-20 — Venetoclax Added to Fludarabine + Busulfan Prior to Transplant and to Maintenance Therapy for AML, MDS, and MDS/MPN: Parallel conditioning-intensification axis: a phase I/II trial adds venetoclax to the FluBu backbone (and continues it as post-transplant maintenance with HMA) in AML/MDS/CMML/MDS-MPN-U — represents a BCL2-inhibitor intensification of FluBu distinct from the TBI-intensification axis tested here. (novelty: 3)
• 2026-05-15 — Chemotherapy (Decitabine in Combination With FLAG-Ida) and Total-Body Irradiation Followed by Donor Stem Cell Transplant for the Treatment of Adults With Myeloid Malignancies at High Risk of Relapse: Parallel conditioning-intensification trial: a phase I/II study adds decitabine (HMA) to a FLAG-Ida + TBI backbone in high-risk AML/MDS/CMML, representing a chemo+HMA intensification axis distinct from the FluBu radiation-intensification axis tested here. (novelty: 3)
• 2026-05-15 — Prospective Single-Arm Clinical Study of Thiotepa-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Chronic Myelomonocytic Leukemia: Adjacent conditioning trial: a prospective single-arm study adds thiotepa to a fludarabine/busulfan backbone (± ATG) specifically for intermediate-2/high-risk CMML, representing a parallel axis of intensification (alkylator addition) distinct from the TBI-intensification axis tested here. (novelty: 3)
• 2026-04-08 — Reduced Intensity Allogeneic HCT in Advanced Hematologic Malignancies w/T-Cell Depleted Graft: Tangentially related: a separate trial pairs RIC with T-cell depleted, immunoregulatory-enriched grafts in advanced hematologic malignancies — an alternative axis (graft engineering) for managing toxicity in older/unfit patients beyond conditioning intensity choice. (novelty: 3)
• 2026-04-03 — Fludarabine and Busulfan vs. Fludarabine, Busulfan and Total Body Irradiation: Single-institution randomized trial (n≈80, John Theurer/Hackensack) comparing FluBu vs FluBu+low-dose TBI conditioning in myeloid malignancies including MPNs, with 1-year relapse rate and transplant-related toxicity as primary endpoints — establishes the prospective comparison this page is built around. (novelty: 3)

Open questions

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