Cladribine‐ and decitabine‐containing conditioning regimen has a low post‐transplant relapse rate in patients with relapsed or refractory acute myeloid leukemia and high‐risk myelodysplastic syndrome

Author:

Tong Xiwen1,Li Mengyuan1,Jin Jie1,Li Yi1,Li Li1,Peng Yizhou1,Huang Lifang1,Xu Bin1,Meng Fankai1,Mao Xia1ORCID,Huang Liang1,Huang Wei1,Zhang Donghua1ORCID

Affiliation:

1. Department of Hematology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China

Abstract

AbstractTo reduce the risk of relapse after allogeneic hematopoietic stem cell transplantation (allo‐HSCT), there have been continuing efforts to optimize the conditioning regimens. Our study aimed to analyze the risk factors associated with the relapse of relapsed/refractory (R/R), high‐risk acute myeloid leukemia (AML) and high‐risk myelodysplastic syndrome (MDS) post‐transplant and the efficacy of a new conditioning regimen involving decitabine and cladribine. Clinical data of 125 patients with R/R AML, high‐risk AML and high‐risk MDS who underwent allo‐HSCT were collected. In addition, 35 patients with R/R AML, high‐risk AML and high‐risk MDS received treatment with a new conditioning regimen including decitabine and cladribine. Cox regression analysis was used to identify risk factors associated with OS, RFS and relapse. Among 125 patients who underwent allo‐HSCT, CR before allo‐HSCT and matched sibling donors were independent protective factors for OS. DNMT3A abnormality was an independent risk factor for both relapse and RFS. Among 35 patients who received a new conditioning regimen containing decitabine and cladribine, only six patients relapsed and 1‐year cumulative incidence of relapse was 11.7%. Moreover, this new regimen showed efficient MRD clearance early after allo‐HSCT. The combined decitabine‐ and cladribine‐based conditioning regimen showed a low relapse rate and a high survival without an increased incidence of GVHD or adverse effects and thus has potential for use in allo‐HSCT for R/R AML, high‐risk AML and high‐risk MDS.

Publisher

Wiley

Subject

Cancer Research,Oncology

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1. Epigenetic therapy: Research progress of decitabine in the treatment of solid tumors;Biochimica et Biophysica Acta (BBA) - Reviews on Cancer;2024-03

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