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Our study aimed to analyze the risk factors associated with the relapse of relapsed\/refractory (R\/R), high\u2010risk acute myeloid leukemia (AML) and high\u2010risk myelodysplastic syndrome (MDS) post\u2010transplant and the efficacy of a new conditioning regimen involving decitabine and cladribine. Clinical data of 125 patients with R\/R AML, high\u2010risk AML and high\u2010risk MDS who underwent allo\u2010HSCT were collected. In addition, 35 patients with R\/R AML, high\u2010risk AML and high\u2010risk MDS received treatment with a new conditioning regimen including decitabine and cladribine. Cox regression analysis was used to identify risk factors associated with OS, RFS and relapse. Among 125 patients who underwent allo\u2010HSCT, CR before allo\u2010HSCT and matched sibling donors were independent protective factors for OS. DNMT3A abnormality was an independent risk factor for both relapse and RFS. Among 35 patients who received a new conditioning regimen containing decitabine and cladribine, only six patients relapsed and 1\u2010year cumulative incidence of relapse was 11.7%. Moreover, this new regimen showed efficient MRD clearance early after allo\u2010HSCT. The combined decitabine\u2010 and cladribine\u2010based conditioning regimen showed a low relapse rate and a high survival without an increased incidence of GVHD or adverse effects and thus has potential for use in allo\u2010HSCT for R\/R AML, high\u2010risk AML and high\u2010risk MDS.<\/jats:p>","DOI":"10.1002\/ijc.34419","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T12:04:35Z","timestamp":1672747475000},"page":"2123-2133","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cladribine\u2010 and decitabine\u2010containing conditioning regimen has a low post\u2010transplant relapse rate in patients with relapsed or refractory acute myeloid leukemia and high\u2010risk myelodysplastic syndrome"],"prefix":"10.1002","volume":"152","author":[{"given":"Xiwen","family":"Tong","sequence":"first","affiliation":[{"name":"Department of Hematology, Tongji Hospital, Tongji Medical College 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