Clinical observation of maintenance treatment with low-dose decitabine after transplantation for patients with high-risk acute lymphoblastic leukemia
10.3760/cma.j.issn.1009-9921.2019.08.005
- VernacularTitle:小剂量地西他滨用于高危急性淋巴细胞白血病移植后维持治疗的临床观察
- Author:
Jia LIU
1
;
Xinsheng XIE
;
Dingming WAN
;
Weijie CAO
;
Haizhou XING
;
Zhongxing JIANG
;
Ling SUN
;
Wenwen DING
;
Zhenkun DONG
;
Yanfang LIU
;
Hui SUN
;
Rong GUO
Author Information
1. 郑州大学第一附属医院血液内科 450052
- Keywords:
Leukemia,lymphocytic,acute;
Allogeneic hematopoietic stem cell transplantation;
Recurrence;
Low-dose decitabine
- From:
Journal of Leukemia & Lymphoma
2019;28(8):473-478
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of maintenance treatment with low-dose decitabine after allogeneic stem cell transplantation (allo-HSCT) for high-risk acute lymphoblastic leukemia (ALL). Methods The data of 10 patients with high-risk ALL who received maintenance therapy with low-dose decitabine after allo-HSCT in the First Affiliated Hospital of Zhengzhou University from July 2016 to March 2018 was collected. The incidence of post-transplant relapse and graft-versus-host disease (GVHD) and the safety of the treatment protocol were analyzed. The cumulative incidence of relapse (CIR) rate, disease-free survival (DFS) rate and overall survival (OS) rate were estimated by Kaplan-Meier method. Results Two patients relapsed and the median relapse time of these 10 patients was 575 days after transplantation. The 1-year CIR, OS and DSF rates were 16.7%, 100.0% and 83.3%, respectively. At the end of follow-up, the DFS time after transplantation of 2 patients with p53 mutation were 23 months and 11 months, respectively. There was no induction or alleviation of GVHD caused by decitabine treatment. Nine patients developed grade Ⅰ-Ⅱmyelosuppression. Three patients had unexplained thrombocytopenia after transplantation and their platelet counts recovered after decitabine treatment. Conclusion Maintenance therapy with low-dose decitabine has low hematologic toxicity without increasing GVHD, which could be a maintenance treatment option to prevent relapse after transplantation for patients with high-risk ALL.
