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Successful HSCT requires adequate myeloablation to create space in the bone marrow microenvironment for donor haematopoietic stem and progenitor cells. Standard conditioning with busulfan and cyclophosphamide (BuCy), although widely used, may not completely clear recipient cells and can cause significant toxicity. Roxadustat (FG\u20104592), a hypoxia\u2010inducible factor prolyl hydroxylase inhibitor used to treat renal anaemia, modulates HIF\u20101\u03b1 stability and influences erythropoiesis, iron metabolism and cellular stress responses. Here, we investigated whether co\u2010administration of FG\u20104592 during BuCy conditioning improves myeloablation efficiency and enhances donor\u2010cell engraftment. Our results show that FG\u20104592 increases the sensitivity of bone marrow mononuclear cell (BM\u2010MNC) populations to BuCy conditioning, promoting deeper depletion of both haematopoietic and non\u2010haematopoietic recipient cells. This improved clearance supports enhanced donor\u2010cell residency following transplantation. Furthermore, in\n                    <jats:italic>\u03b2<\/jats:italic>\n                    <jats:sup>\n                      <jats:italic>654<\/jats:italic>\n                    <\/jats:sup>\n                    thalassaemia mice, FG\u20104592 alleviated anaemia and reduced splenic iron deposition after HSCT. These findings suggest that FG\u20104592 can serve as an effective adjuvant to standard myeloablation regimens, supporting improved engraftment and hematologic recovery. To our knowledge, this is the first study demonstrating that a HIF\u2010PH inhibitor can enhance conditioning efficiency during HSCT.\n                  <\/jats:p>","DOI":"10.1111\/cpr.70230","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:30:25Z","timestamp":1783675825000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimising Haematopoietic Stem Cell Transplantation: Enhancing Myeloablation Sensitivity and Alleviating Anaemia Using Roxadustat (\n                    <scp>FG<\/scp>\n                    \u20104592)"],"prefix":"10.1111","volume":"59","author":[{"given":"Guanheng","family":"Yang","sequence":"first","affiliation":[{"name":"Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Department of Histology, Embryology, Genetics and Developmental Biology Shanghai Jiao Tong 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Developmental Molecular Biology, Shanghai Key Laboratory of Embryo and Reproduction Engineering  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenchen","family":"Shen","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"NHC Key Laboratory of Medical Embryogenesis and Developmental Molecular Biology, Shanghai Key Laboratory of Embryo and Reproduction Engineering  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Sang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"NHC Key Laboratory of Medical Embryogenesis and Developmental Molecular Biology, Shanghai Key Laboratory of Embryo and Reproduction Engineering  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuli","family":"Gong","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"NHC Key Laboratory of Medical Embryogenesis and Developmental Molecular Biology, Shanghai Key Laboratory of Embryo and Reproduction Engineering  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Zhen","family":"Huang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"NHC Key Laboratory of Medical Embryogenesis and Developmental Molecular Biology, Shanghai Key Laboratory of Embryo and Reproduction Engineering  Shanghai 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