Conditioning regimen intensity and low-dose azacitidine maintenance after allogeneic hematopoietic cell transplantation for acute myeloid leukemia

被引：23

作者：

Ali, Naveed ^{[1
]}

Tomlinson, Benjamin ^{[1
]}

Metheny, Leland ^{[1
]}

Goldstein, Steven C. ^{[2
]}

Fu, Pingfu ^{[3
]}

Cao, Shufen ^{[3
]}

Caimi, Paolo ^{[1
]}

Patel, Rushang D. ^{[2
]}

Varela, Juan Carlos ^{[2
]}

Andrade, Luisa ^{[1
]}

Balls, Jason W. ^{[2
]}

Baer, Linda ^{[1
]}

Smith, Megan ^{[2
]}

Smith, Tori ^{[2
]}

Nelson, Megan ^{[2
]}

de Lima, Marcos ^{[1
]}

Mori, Shahram ^{[2
]}

机构：

[1] Case Western Reserve Univ, Univ Hosp Cleveland, Seidman Canc Ctr, Stem Cell Transplant Program, 11100 Euclid Ave, Cleveland, OH 44106 USA

[2] AdventHlth Hosp, Dept Blood & Marrow Transplant, Orlando, FL USA

[3] Case Western Reserve Univ, Dept Populat & Quantitat Hlth Sci, Cleveland, OH 44106 USA

来源：

LEUKEMIA & LYMPHOMA | 2020年 / 61卷 / 12期

关键词：

Azacitidine maintenance; acute myeloid leukemia; myelodysplastic syndrome; hematopoietic cell transplantation; ACUTE MYELOGENOUS LEUKEMIA; RISK MYELODYSPLASTIC SYNDROME; DISEASE; GRAFT; SURVIVAL; RELAPSE; BLOOD; MODULATION; EXPRESSION; THERAPY;

D O I：

10.1080/10428194.2020.1789630

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Azacitidine (AZA) maintenance following allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) may reduce relapse risk and improve survival. Given logistic and toxicity-related challenges, identifying subgroups appropriate for this approach is an unmet need. Using data from two centers, we retrospectively compared event-free survival (EFS) and overall survival (OS) of AML and MDS patients who received AZA maintenance (n = 59) with historic controls (n = 90). Controls were selected according to the following criteria: no death, relapse, or Grade III-IV acute GVHD for 100 days after transplant. In multivariable analysis, AZA maintenance yielded significantly improved EFS (p = 0.019) and OS (p = 0.011). Outcomes differed according to regimen intensity. For reduced-intensity transplant, EFS (p = 0.004) and OS (p = 0.004) were significantly improved and equivalent to myeloablative transplant. A significant benefit following myeloablative transplant was not observed. Within the limitation of its retrospective nature, this study suggests that AZA maintenance improves outcomes following reduced-intensity HCT, comparable to myeloablative HCT.

引用

页码：2839 / 2849

页数：11

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