Decitabine induction with myeloablative conditioning and allogeneic hematopoietic stem cell transplantation in high-risk patients with myeloid malignancies is associated with a high rate of infectious complications.

Leukemia Research
Christopher R D'AngeloMark Juckett

Abstract

Patients with high-risk myelodysplastic syndrome or acute myeloid leukemia have an increased risk of death following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Decitabine has minimal non-hematologic toxicity and proven efficacy in myeloid diseases, and post-transplant cyclophosphamide (PTCy) has reduced rates of graft-versus-host-disease (GVHD). We hypothesized that decitabine induction with allo-HSCT and PTCy would improve outcomes in a high-risk myeloid disease population. We performed a phase-II trial of decitabine at 20 mg/m2 for 10 days followed by allo-HSCT using a myeloablative regimen of fludarabine, IV busulfan and 4 Gy total body irradiation with PTCy for GVHD prophylaxis. Twenty patients underwent decitabine induction and 17 patients proceeded to transplant per protocol. Median overall survival from decitabine induction was 210 days (95 % CI 122-not reached). All patients developed grade 4 neutropenia after decitabine, eleven patients (55 %) developed grade 3-4 infections, and 5 cases were fatal. There were 5/20 (25 %) long-term survivors with a median follow-up of 3.6 years. Decitabine induction followed by myeloablative allo-HSCT in a high-risk population was associated with a high risk of infe...Continue Reading

References

Dec 16, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Bruce D ChesonUNKNOWN International Working Group for Diagnosis, Standardization of Response Criteria, Treatment Outcomes, and Reporting Standards
Jun 21, 2007·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·James A RussellDouglas A Stewart
Jul 20, 2007·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Taichun QinJean-Pierre J Issa
May 21, 2008·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Leo LuznikEphraim J Fuchs
Mar 12, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Dimitrios P KontoyiannisPeter G Pappas
Apr 7, 2010·Proceedings of the National Academy of Sciences of the United States of America·William BlumGuido Marcucci
Jul 14, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Michel DuvalDaniel Weisdorf
Nov 30, 2010·Bone Marrow Transplantation·L BühlmannM Stern
Jan 25, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Alison G Freifeld Infectious Diseases Society of America
Feb 5, 2015·Transplant Infectious Disease : an Official Journal of the Transplantation Society·R CrocchioloL Castagna
Apr 6, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Bart L ScottMitchell E Horwitz
Jan 18, 2018·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Rémy DuléryMohamad Mohty
Sep 9, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Yi-Geng CaoMing-Zhe Han

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