Acute Myeloblastic Leukemia and Myelodysplastic Syndrome: Azacitidine for Prophylactic and Preventive Purposes after Allogeneic Hematopoietic Stem Cell Transplantation

Content Provider	Semantic Scholar
Author	Ovechkina, Varvara N. Bondarenko, Sergey Nikolaevich Morozova, Elena Vladislavovna Moiseev, Ivan S. Slesarchuk, Oa Smirnova, Ag Uspenskaya, O. V. Gudozhnikova, YaV Osipova, Anna A. Sergeev, Vladislav S. Mamaev, Nikolay Zubarovskaya, Ludmila S. Afanas’ev, Bv
Copyright Year	2017
Abstract	Aim. To evaluate the eff ectiveness of preventive and prophylactic post-transplantation therapy using azacitidine (5-AZA) in patients at high risk of post-transplantation relapse. Methods. 136 patients were included in the study performed by the pairwise comparison: 68 of them received 5-AZA after allo-HSCT and 68 patients were included in the historical control group. 5-AZA was prescribed for prophylactic or preventive purposes. The results were assessed according to the OS, RR, EFS, DUM, and relapse-free and GVHR-free survival. Results. 1-year OS was 76 % in the 5-AZA group (95% CI 60–84 %) and 44 % in the reference group (95% CI 33–55 %) (p = 0.001); 2-year OS was 63 % (95% CI 39–67 %) and 37 % (95% CI 26–48 %) (p = 0.007), respectively. The relapse rate (RR) in the 5-AZA group was 34 % (95% CI 22–46 %) during 1 year and 51 % (95% CI 38–64 %) in the reference group (p = 0.02). 1and 2-year disease unrelated mortality (DUM) was similar: 5 % in the 5-AZA group (95% CI 0.1–14.0 %) and 25 % (95% CI 13–37 %) in the reference group (p = 0.005). 1-year EFS was 76 % in the 5-AZA group (95% CI 61–85 %) and 44 % in the reference group (95% CI 33–55 %) (p = 0.001); 2-year EFS was 63 % (95% CI 39–67 %) and 37 % (95% CI 26–48 %) (p = 0.01), respectively. 1-year relapse-free and GVHR-free survival was 55 % in the 5-AZA group (95% CI 41–69 %) and 28 % in the reference group (95% CI 17–39 %) (p = 0.001); 2-year relapse-free and GVHR-free survival was 47 % (95% CI 32–62 %) and 27 % (95% CI 17–37 %) (p = 0.002), respectively. Conclusion. The use of 5-AZA for prophylactic and preventive purposes after allo-HSCT does not increase the risk of GVHR and DUM, does not suppress the GVL eff ect and can be used in 46 В.Н. Овечкина и др. КЛИНИЧЕСКАЯ ОНКОГЕМАТОЛОГИЯ зоваться в комбинации с инфузией донорских лимфоцитов (ИДЛ) в безопасном режиме. Терапия 5-AZA безопасна в ранний срок после аллоТГСК. Препарат не подавляет развитие РТПЛ и может использоваться у пациентов с высоким риском для предотвращения ранних посттрансплантационных рецидивов. Применение 5-AZA совместно с ИДЛ не увеличивает частоту тяжелой РТПХ. Ключевые слова: острый миелобластный лейкоз, миелодиспластический синдром, аллогенная трансплантация гемопоэтических стволовых клеток, гипометилирующая терапия, азацитидин. Получено: 18 июля 2016 г. Принято в печать: 17 декабря 2016 г. Для переписки: Варвара Николаевна Овечкина, ул. Льва Толстого, д. 6/8, Санкт-Петербург, Российская Федерация, 197022; тел.: 8(812)338-62-72; e-mail: ovetchkina@gmail.com Для цитирования: Овечкина В.Н., Бондаренко С.Н., Морозова Е.В. и др. Острый миелобластный лейкоз и миелодиспластический синдром: применение азацитидина с профилактической и превентивной целью после аллогенной трансплантации гемопоэтических стволовых клеток. Клиническая онкогематология. 2017;10(1):45–51. DOI: 10.21320/2500-2139-2017-10-1-45-51 combination with the donor lymphocyte infusion (DLI). The therapy with 5-AZA is safe during the early period after allo-HSCT. The drug does not suppress the GVL eff ect and can be used in high risk patients to prevent early post-transplantation relapse. The use of 5-AZA in combination with DLI does not increase the incidence of severe GVHR.
Starting Page	45
Ending Page	51
Page Count	7
File Format	PDF HTM / HTML
DOI	10.21320/2500-2139-2017-10-1-45-51
Volume Number	10
Alternate Webpage(s)	http://bloodjournal.ru/wp-content/uploads/2017/01/6.pdf
Alternate Webpage(s)	https://doi.org/10.21320/2500-2139-2017-10-1-45-51
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article