Clinical study of decitabine-intensified conditioning regimen prior to hematopoieticstem cell transplantation in the treatment of refractory/relapse acute myeloid leukemia
10.7644/j.issn.1674-9960.2017.10.010
- VernacularTitle:地西他滨强化预处理方案造血干细胞移植治疗难治复发急性髓性白血病的临床研究
- Author:
Long-Can CHENG
1
;
Na LIU
;
Jian-Lin CHEN
;
Bo-Tao LI
;
Chen XU
;
Yu-Hang LI
;
Liang-Ding HU
Author Information
1. 军事医学科学院附属医院造血干细胞移植科
- Keywords:
decitabine;
hematopoietic stem cell transplantation;
refractory/relapse acute myeloid leukemia
- From:
Military Medical Sciences
2017;41(10):830-834
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the treatment results of 44 consecutive patients with refractory/relapse acute myeloid leukemia( AML) not in remission who received allogeneic hematopoietic stem cell transplantation ( allo-HSCT ) following decitabine (DAC)-intensified conditioning regimen (18) and idarubicin(IDA)-intensified conditioning regimen (26). Methods We conducted a retrospective study to evaluate the outcome of 44 consecutive patients with refractory/relapse AML not in remission who received allo-HSCT from 2009 July to 2016 May.Eighteen of them were given DAC-intensified conditioning regimen and 26 of them were given IDA-intensified conditioning regimen prior to allo-HSCT.The effects of DAC and IDA intensified conditioning regimen on the patients ' engraftment, transplant-related mortality, survival and occurrence of graft versus host disease(GVHD)were analyzed.Results and Conclusion In the DAC group, 7(38.9％) patients had acute GVHD (aGVHD).Among them,2 patients had grade Ⅰ aGVHD,5 patients had grade Ⅱ aGVHD.In the IDA group, 16(61.5％)patients had aGVHD.Among them,9 patients had grade Ⅰ aGVHD, 6 patients had grade Ⅱ aGVHD and 1 patient had grade ⅢaGVHD.In the IDA group, 9 of 26(34.6％) patients experienced leukemia relapse , all of them died due to the lack of effective therapies .In the DAC group, 4 of 18(22.2％) patients experienced leukemia relapse, 2 of them got long-term survival throughout salvage therapies .For the DAC group and IDA group , the 1-year probabilities of overall survival (OS) and leukemia-free survival (LFS) were 65.0％ versus 57.7％ (P=0.602) and 53.5％versus 57.7％(P=0.910), respectively.DAC-intensified conditioning regimen before allo-HSCT in the treatment of refractory/relapse AML is safe and effective.
