Effect and safety of 10-day decitabine-containing conditioning regimen for allogeneic hematopoietic stem cell transplantation in 31 patients with acute myeloid leukemia/myelodysplastic syndrome.
10.3760/cma.j.issn.0253-2727.2023.06.005
- Author:
Jia LIU
1
;
Yi Geng CAO
1
;
Rong Li ZHANG
1
;
Wei Hua ZHAI
1
;
Xin CHEN
1
;
Qiao Ling MA
1
;
Ai Ming PANG
1
;
Dong Lin YANG
1
;
Jia Lin WEI
1
;
Yi HE
1
;
Si Zhou FENG
1
;
Ming Zhe HAN
1
;
Er Lie JIANG
1
Author Information
1. State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China.
- Publication Type:Journal Article
- Keywords:
10-day decitabine;
Acute myeloid leukemia;
Allogeneic hematopoietic stem cell transplantation;
Conditioning regimen;
Myelodysplastic syndrome
- MeSH:
Male;
Female;
Humans;
Decitabine;
Myelodysplastic Syndromes/therapy*;
Leukemia, Myeloid, Acute/complications*;
Disease-Free Survival;
Hematopoietic Stem Cell Transplantation/adverse effects*;
Recurrence;
Chronic Disease;
Graft vs Host Disease/etiology*;
Transplantation Conditioning/adverse effects*;
Bronchiolitis Obliterans Syndrome;
Retrospective Studies
- From:
Chinese Journal of Hematology
2023;44(6):472-478
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the early effect and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with a 10-day decitabine-containing conditioning regimen in the treatment of acute myeloid leukemia (AML) /myelodysplastic syndrome (MDS) . Methods: From April 2021 to May 2022, 31 AML/MDS patients who received allo-HSCT with a 10-day decitabine-containing conditioning regimen were analyzed. Results: AML (n=10), MDS-AML (n=6), CMML-AML (n=1), and MDS (n=14) were identified in 31 patients, 16 males, and 15 females, with a median age of 41 (20-55) yr. Neutrophils and platelets were successfully implanted in 31 patients (100%), with a median implantation duration of 12 (9-30) and 14 (9-42) days, respectively. During the preconditioning period, 16 patients (51.6%) developed oral mucositis, with 15 cases of Ⅰ/Ⅱ grade (48.4%) and one case of Ⅲ grade (3.2%). After transplantation, 13 patients (41.9%) developed CMV viremia, six patients (19.4%) developed hemorrhagic cystitis, and four patients (12.9%) developed a local infection. The median time of acute graft versus host disease (aGVHD) following transplantation was 33 (12-111) days. The cumulative incidence of aGVHD and Ⅲ/Ⅳ grade aGVHD was 41.9% (95% CI 26.9%-61.0%) and 22.9% (95% CI 13.5%-47.5%), respectively. There was no severe cGVHD, and mild and moderate chronic GVHD (cGVHD) incidence was 23.5% (95% CI 12.1%-43.6%). As of November 30, 2022, only one of the 31 patients had relapsed, with a 1-yr cumulative relapse rate (CIR) of 3.2% (95% CI 0.5%-20.7%). There was only one relapse patient death and no non-relapse deaths. The 1-yr overall survival (OS) and disease-free survival (DFS) rates were 92.9% (95% CI 80.3%-100%) and 96.8% (95% CI 90.8%-100%), respectively. Conclusions: A 10-day decitabine-containing conditioning regimen for allo-HSCT reduced relapse and was safe and feasible in treating AML/MDS.
