Generalist in allogeneic hematopoietic stem cell transplantation for MDS or AML: Epigenetic therapy
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment for patients with myeloid malignancies such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). However, relapse and graft-versus-host disease (GvHD) still affect the survival of patien...
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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1034438/full |
| _version_ | 1811181649473306624 |
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| author | Guancui Yang Guancui Yang Guancui Yang Xiang Wang Xiang Wang Shiqin Huang Shiqin Huang Ruihao Huang Ruihao Huang Jin Wei Xiaoqi Wang Xiaoqi Wang Xi Zhang Xi Zhang Xi Zhang |
| author_facet | Guancui Yang Guancui Yang Guancui Yang Xiang Wang Xiang Wang Shiqin Huang Shiqin Huang Ruihao Huang Ruihao Huang Jin Wei Xiaoqi Wang Xiaoqi Wang Xi Zhang Xi Zhang Xi Zhang |
| author_sort | Guancui Yang |
| collection | DOAJ |
| description | Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment for patients with myeloid malignancies such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). However, relapse and graft-versus-host disease (GvHD) still affect the survival of patients who receive allo-HSCT, and more appropriate therapeutic strategies should be applied at all stages of transplantation to prevent these adverse events. The use of epigenetics agents, such as hypomethylating agents (HMAs), has been explored to decrease the risk of relapse by epigenetic modulation, which is especially effective among AML patients with poor mutations in epigenetic regulators. Furthermore, epigenetic agents have also been regarded as prophylactic methods for GvHD management without abrogating graft versus leukemia (GvL) effects. Therefore, the combination of epigenetic therapy and HSCT may optimize the transplantation process and prevent treatment failure. Existing studies have investigated the feasibility and effectiveness of using HMAs in the pretransplant, transplant and posttransplant stages among MDS and AML patients. This review examines the application of HMAs as a bridge treatment to reduce the tumor burden and the determine appropriate dose during allo-HSCT. Within this review, we also examine the efficacy and safety of HMAs alone or HMA-based strategies in posttransplant settings for MDS and AML. Finally, we provide an overview of other epigenetic candidates, which have been discussed in the nontransplant setting. |
| first_indexed | 2024-04-11T09:21:07Z |
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| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-11T09:21:07Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-1e2aee25f5494827a106082b485302c92022-12-22T04:32:12ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.10344381034438Generalist in allogeneic hematopoietic stem cell transplantation for MDS or AML: Epigenetic therapyGuancui Yang0Guancui Yang1Guancui Yang2Xiang Wang3Xiang Wang4Shiqin Huang5Shiqin Huang6Ruihao Huang7Ruihao Huang8Jin Wei9Xiaoqi Wang10Xiaoqi Wang11Xi Zhang12Xi Zhang13Xi Zhang14Medical Center of Hematology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaState Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hematology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaMedical Center of Hematology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaState Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, ChinaMedical Center of Hematology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaState Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, ChinaMedical Center of Hematology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaState Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hematology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaMedical Center of Hematology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaState Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, ChinaMedical Center of Hematology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaState Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hematology, Affiliated Hospital of North Sichuan Medical College, Nanchong, ChinaAllogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment for patients with myeloid malignancies such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). However, relapse and graft-versus-host disease (GvHD) still affect the survival of patients who receive allo-HSCT, and more appropriate therapeutic strategies should be applied at all stages of transplantation to prevent these adverse events. The use of epigenetics agents, such as hypomethylating agents (HMAs), has been explored to decrease the risk of relapse by epigenetic modulation, which is especially effective among AML patients with poor mutations in epigenetic regulators. Furthermore, epigenetic agents have also been regarded as prophylactic methods for GvHD management without abrogating graft versus leukemia (GvL) effects. Therefore, the combination of epigenetic therapy and HSCT may optimize the transplantation process and prevent treatment failure. Existing studies have investigated the feasibility and effectiveness of using HMAs in the pretransplant, transplant and posttransplant stages among MDS and AML patients. This review examines the application of HMAs as a bridge treatment to reduce the tumor burden and the determine appropriate dose during allo-HSCT. Within this review, we also examine the efficacy and safety of HMAs alone or HMA-based strategies in posttransplant settings for MDS and AML. Finally, we provide an overview of other epigenetic candidates, which have been discussed in the nontransplant setting.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1034438/fullhematopoietic stem cell transplantationepigenetic therapygraft-versus-host diseasemyelodysplastic syndromeacute myeloid leukemia |
| spellingShingle | Guancui Yang Guancui Yang Guancui Yang Xiang Wang Xiang Wang Shiqin Huang Shiqin Huang Ruihao Huang Ruihao Huang Jin Wei Xiaoqi Wang Xiaoqi Wang Xi Zhang Xi Zhang Xi Zhang Generalist in allogeneic hematopoietic stem cell transplantation for MDS or AML: Epigenetic therapy Frontiers in Immunology hematopoietic stem cell transplantation epigenetic therapy graft-versus-host disease myelodysplastic syndrome acute myeloid leukemia |
| title | Generalist in allogeneic hematopoietic stem cell transplantation for MDS or AML: Epigenetic therapy |
| title_full | Generalist in allogeneic hematopoietic stem cell transplantation for MDS or AML: Epigenetic therapy |
| title_fullStr | Generalist in allogeneic hematopoietic stem cell transplantation for MDS or AML: Epigenetic therapy |
| title_full_unstemmed | Generalist in allogeneic hematopoietic stem cell transplantation for MDS or AML: Epigenetic therapy |
| title_short | Generalist in allogeneic hematopoietic stem cell transplantation for MDS or AML: Epigenetic therapy |
| title_sort | generalist in allogeneic hematopoietic stem cell transplantation for mds or aml epigenetic therapy |
| topic | hematopoietic stem cell transplantation epigenetic therapy graft-versus-host disease myelodysplastic syndrome acute myeloid leukemia |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1034438/full |
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