Universität zu Köln

Craddock, Charles ORCID: 0000-0001-5041-6678, Labopin, Myriam, Robin, Marie ORCID: 0000-0003-1388-9876, Finke, Juergen, Chevallier, Patrice, Yakoub-Agha, Ibrahim ORCID: 0000-0003-4524-8782, Bourhis, Jean Henri, Sengelov, Henrik ORCID: 0000-0002-5991-2958, Blaise, Didier, Luft, Thomas, Hallek, Michael, Kroeger, Nicolaus, Nagler, Arnon and Mohty, Mohamad (2016). Clinical activity of azacitidine in patients who relapse after allogeneic stem cell transplantation for acute myeloid leukemia. Haematologica, 101 (7). S. 879 - 884. PAVIA: FERRATA STORTI FOUNDATION. ISSN 0390-6078

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Abstract

Disease relapse is the most common cause of treatment failure after allogeneic stem cell transplantation for acute myeloid leukemia and myelodysplastic syndromes, yet treatment options for such patients remain extremely limited. Azacitidine is an important new therapy in high-risk myelodysplastic syndromes and acute myeloid leukemia but its role in patients who relapse post allograft has not been defined. We studied the tolerability and activity of azacitidine in 181 patients who relapsed after an allograft for acute myeloid leukemia (n=116) or myelodysplastic syndromes (n=65). Sixty-nine patients received additional donor lymphocyte infusions. Forty-six of 157 (25%) assessable patients responded to azacitidine therapy: 24 (15%) achieved a complete remission and 22 a partial remission. Response rates were higher in patients transplanted in complete remission (P=0.04) and those transplanted for myelodysplastic syndromes (P=0.023). In patients who achieved a complete remission, the 2-year overall survival was 48% versus 12% for the whole population. Overall survival was determined by time to relapse post transplant more than six months (P=0.001) and percentage of blasts in the bone marrow at time of relapse (P=0.01). The concurrent administration of donor lymphocyte infusion did not improve either response rates or overall survival in patients treated with azacitidine. An azacitidine relapse prognostic score was developed which predicted 2-year overall survival ranging from 3%-37% (P=0.00001). We conclude that azacitidine represents an important new therapy in selected patients with acute myeloid leukemia/myelodysplastic syndromes who relapse after allogeneic stem cell transplantation. Prospective studies to confirm optimal treatment options in this challenging patient population are required.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Craddock, Charles UNSPECIFIED orcid.org/0000-0001-5041-6678 UNSPECIFIED Labopin, Myriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Robin, Marie UNSPECIFIED orcid.org/0000-0003-1388-9876 UNSPECIFIED Finke, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Chevallier, Patrice UNSPECIFIED UNSPECIFIED UNSPECIFIED Yakoub-Agha, Ibrahim UNSPECIFIED orcid.org/0000-0003-4524-8782 UNSPECIFIED Bourhis, Jean Henri UNSPECIFIED UNSPECIFIED UNSPECIFIED Sengelov, Henrik UNSPECIFIED orcid.org/0000-0002-5991-2958 UNSPECIFIED Blaise, Didier UNSPECIFIED UNSPECIFIED UNSPECIFIED Luft, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Nicolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Nagler, Arnon UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohty, Mohamad UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-270915
DOI:	10.3324/haematol.2015.140996
Journal or Publication Title:	Haematologica
Volume:	101
Number:	7
Page Range:	S. 879 - 884
Date:	2016
Publisher:	FERRATA STORTI FOUNDATION
Place of Publication:	PAVIA
ISSN:	0390-6078
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RISK MYELODYSPLASTIC SYNDROMES; DONOR LYMPHOCYTE INFUSIONS; CONVENTIONAL CARE REGIMENS; REGULATORY T-CELLS; SALVAGE THERAPY; WORKING PARTY; AML; SURVIVAL; ANTIGEN; ADULTS Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27091