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Biol Blood Marrow Transplant. 2017 Jan;23(1):176-179. doi: 10.1016/j.bbmt.2016.10.016. Epub 2016 Oct 24.

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

Author information

1
Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington; Seattle Cancer Care Alliance, Seattle, Washington.
2
Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington; Seattle Cancer Care Alliance, Seattle, Washington. Electronic address: bscott@fredhutch.org.

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.

KEYWORDS:

Azacitidine; Clonal evolution; Early post-transplantation relapse; Myelodysplastic syndromes

PMID:
27789363
DOI:
10.1016/j.bbmt.2016.10.016
[Indexed for MEDLINE]
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