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Factors Determining Responses to Azacitidine in Patients with Myelodysplastic Syndromes and Acute Myeloid Leukemia with Early Post-Transplantation Relapse: A Prospective Trial.

Abstract
Retrospective analyses suggest a benefit of therapy with hypomethylating agents in patients with myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) who relapse after allogeneic hematopoietic cell transplantation (HCT). We conducted a prospective trial in 39 patients with MDS or AML who relapsed within 100 days of HCT. Relapse was documented by morphology, flow cytometry, or cytogenetics. Treatment consisted of 5-azacitidine, 75 mg/m2/day for 7 days, administered every 28 days. Patients were followed by sequential marrow examinations, and responses were assessed at 6 months. There were 3 complete remissions and 9 partial remissions (30%); an additional 3 patients had stable disease by International Working Group criteria. In multivariate analysis, only the type of induction chemotherapy given before HCT was significantly associated with post-HCT response to 5-azacitidine and overall survival (P = .004). These data support the use of hypomethylating therapy for post-HCT relapse in patients with MDS and AML and suggest that pre-HCT therapy may affect the likelihood of response to this salvage approach.
AuthorsJanghee Woo, H Joachim Deeg, Barry Storer, Cecilia Yeung, Min Fang, Marco Mielcarek, Bart L Scott
JournalBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 23 Issue 1 Pg. 176-179 (01 2017) ISSN: 1523-6536 [Electronic] United States
PMID27789363 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Antimetabolites, Antineoplastic
  • Azacitidine
Topics
  • Adult
  • Aged
  • Antimetabolites, Antineoplastic (therapeutic use)
  • Azacitidine (administration & dosage, therapeutic use)
  • Female
  • Hematopoietic Stem Cell Transplantation (methods, mortality, standards)
  • Humans
  • Induction Chemotherapy (methods)
  • Leukemia, Myeloid, Acute (mortality, therapy)
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes (mortality, therapy)
  • Recurrence
  • Remission Induction (methods)
  • Survival Rate

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