Thiotepa/busulfan/fludarabine conditioning for CMML allo-HSCT

Current understanding

A prospective single-arm trial is evaluating a thiotepa + busulfan + fludarabine (± ATG) conditioning regimen for allo-HSCT in intermediate-2 or high-risk CMML, a disease where conditioning evidence is sparse. The study addresses an execution-layer gap: once the decision to transplant a higher-risk CMML patient is made, which conditioning backbone optimizes the relapse/toxicity tradeoff. Outcomes are not yet reported.

Evidence log

• 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: cross-connection with decitabine-flagida-tbi-conditioning: Both trials enroll CMML and test conditioning intensification, but along different axes (HMA + intensive chemo + TBI vs. alkylator addition to FluBu); together they frame the open question of how best to intensify conditioning for high-risk myeloid disease. (novelty: 3)

Open questions

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