Universität zu Köln

Kroeger, Nicolaus, Sockel, Katja, Wolschke, Christine, Bethge, Wolfgang, Schlenk, Richard F., Wolf, Dominik, Stadler, Michael, Kobbe, Guido, Wulf, Gerald, Bug, Gesine ORCID: 0000-0003-2359-131X, Schaefer-Eckart, Kerstin, Scheid, Christof, Nolte, Florian, Kroenke, Jan, Stelljes, Matthias, Beelen, Dietrich, Heinzelmann, Marion, Haase, Detlef, Buchner, Hannes, Bleckert, Gabriele ORCID: 0000-0002-4341-9042, Giagounidis, Aristoteles and Platzbecker, Uwe (2021). Comparison Between 5-Azacytidine Treatment and Allogeneic Stem-Cell Transplantation in Elderly Patients With Advanced MDS According to Donor Availability (VidazaAllo Study). J. Clin. Oncol., 39 (30). S. 3318 - 3329. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1527-7755

Full text not available from this repository.

Abstract

PURPOSE In contrast to 5-azacytidine (5-aza), allogeneic stem-cell transplantation (HSCT) represents a curative treatment strategy for patients with myelodysplastic syndromes (MDS), but therapy-related mortality (TRM) limits its broader use in elderly patients with MDS. The present prospective multicenter study compared HSCT following 5-aza pretreatment with continuous 5-aza treatment in patients with higher-risk MDS age 55-70 years. METHODS One hundred ninety patients with a median age of 63 years were enrolled. Patients received 4-6 cycles of 5-aza followed by HLA-compatible HSCT after reduced-intensity conditioning or by continuous 5-aza if no donor was identified. RESULTS Twenty-eight patients did not fulfill inclusion criteria (n = 20), died (n = 2) withdrew informed consent (n = 5), or were excluded for an unknown reason (n = 1). 5-aza induction started in 162 patients, but only 108 (67%) were eligible for subsequent allocation to HSCT (n = 81) or continuation of 5-aza (n = 27) because of disease progression (n = 26), death (n = 12), or other reasons (n = 16). Seven percent died during 5-aza before treatment allocation. The cumulative incidence of TRM after HSCT at 1 year was 19%. The event-free survival and overall survival after 5-aza pretreatment and treatment allocation at 3 years were 34% (95% CI, 22 to 47) and 50% (95% CI, 39 to 61) after allograft and 0% and 32% (95% Cl, 14 to 52) after continuous 5-aza treatment (P < .0001 and P = .12), respectively. Fourteen patients progressing after continuous 5-aza received a salvage allograft from an alternative donor, and 43% were alive at last follow-up. CONCLUSION In older patients with MDS, reduced-intensity conditioning HSCT resulted in a significantly improved event-free survival in comparison with continuous 5-aza therapy. Bridging with 5-aza to HSCT before is associated with a considerable rate of dropouts because of progression, mortality, and adverse events. (C) 2021 by American Society of Clinical Oncology

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kroeger, Nicolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Sockel, Katja UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolschke, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Bethge, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlenk, Richard F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Stadler, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Kobbe, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Wulf, Gerald UNSPECIFIED UNSPECIFIED UNSPECIFIED Bug, Gesine UNSPECIFIED orcid.org/0000-0003-2359-131X UNSPECIFIED Schaefer-Eckart, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, Christof UNSPECIFIED UNSPECIFIED UNSPECIFIED Nolte, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroenke, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Stelljes, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Beelen, Dietrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinzelmann, Marion UNSPECIFIED UNSPECIFIED UNSPECIFIED Haase, Detlef UNSPECIFIED UNSPECIFIED UNSPECIFIED Buchner, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Bleckert, Gabriele UNSPECIFIED orcid.org/0000-0002-4341-9042 UNSPECIFIED Giagounidis, Aristoteles UNSPECIFIED UNSPECIFIED UNSPECIFIED Platzbecker, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-606012
DOI:	10.1200/JCO.20.02724
Journal or Publication Title:	J. Clin. Oncol.
Volume:	39
Number:	30
Page Range:	S. 3318 - 3329
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1527-7755
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE MYELOID-LEUKEMIA; RISK MYELODYSPLASTIC SYNDROMES; MALIGNANCIES WORKING PARTY; SOCIETE FRANCAISE; SCORING SYSTEM; AZACITIDINE; CHEMOTHERAPY; SUBCOMMITTEE; EFFICACY; GREFFE Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60601