Decitabine-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Intermediate- and High-Risk Myelodysplastic Syndrome/Acute Myeloid Leukemia: Potential Decrease in the Incidence of Acute Graft versus Host Disease
Qing Ya Wang,* Yuan Li,* Ze Yin Liang, Yue Yin, Wei Liu, Qian Wang, Yu Jun Dong, Yu Hua Sun, Wei Lin Xu, Han Yun Ren Department of Hematology, Peking University First Hospital, Peking University, Beijing, People’s Republic of China*These authors contributed equally to this workCorresponden...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-12-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/decitabine-containing-conditioning-regimen-for-allogeneic-hematopoieti-peer-reviewed-article-CMAR |
| _version_ | 1811212958536040448 |
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| author | Wang QY Li Y Liang ZY Yin Y Liu W Wang Q Dong YJ Sun YH Xu WL Ren HY |
| author_facet | Wang QY Li Y Liang ZY Yin Y Liu W Wang Q Dong YJ Sun YH Xu WL Ren HY |
| author_sort | Wang QY |
| collection | DOAJ |
| description | Qing Ya Wang,* Yuan Li,* Ze Yin Liang, Yue Yin, Wei Liu, Qian Wang, Yu Jun Dong, Yu Hua Sun, Wei Lin Xu, Han Yun Ren Department of Hematology, Peking University First Hospital, Peking University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuan Li; Han Yun RenDepartment of Hematology, Peking University First Hospital, Peking University, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, People’s Republic of ChinaTel +86 1083575746; +86 1083575680Email drliyuan75@163.com; renhy0813@163.comPurpose: To evaluate the role of Decitabine in the allo-HSCT conditioning regimen for intermediate- and high-risk patients with MDS or AML.Patients and methods: Retrospective analysis of data pertaining to 76 intermediate- and high-risk patients with MDS or AML who underwent allo-HSCT between December 2005 and June 2018 at the Peking University First Hospital. Forty patients received Decitabine-containing conditioning regimen before transplantation, while thirty-six patients received regimen without Decitabine.Results: Over a median follow-up of 40 months (range, 1 to 155), the cumulative incidence of grade II to IV acute graft versus host disease was 12.4% [95% confidence interval (CI) 4.9–30.9%] in the Decitabine group and 41.5% (95% CI 28.1–61.2%) in the non-Decitabine group (P=0.005). On multivariate analysis, Decitabine-containing conditioning regimen was found to protect against grade II to IV aGVHD (HR=0.279, 95% CI 0.102–0.765, P=0.013). Incidence of respiratory infection in the Decitabine and non-Decitabine groups was 22.5% and 52.78%, respectively (P=0.012). No significant between-group difference was observed with respect to 3-year OS, DFS, or RR (P=0.980, 0.959, and 0.573, respectively), while the median relapse time was longer in the Decitabine group [7 months (range, 2–12) versus 3 months (range, 2–4), P=0.171]. Decitabine-containing conditioning showed a tendency for lower relapse rate among higher risk patients, as assessed by IPSS R; however, the between-group difference was not statistically significant (P=0.085).Conclusion: Inclusion of Decitabine in the conditioning regimen for allo-HSCT in intermediate- and high-risk patients may lower the incidence of aGVHD and respiratory infections, and contribute to longer median relapse time.Keywords: myelodysplastic syndrome, acute myeloid leukemia, Decitabine, transplantation conditioning, graft versus host disease, allogeneic hematopoietic stem cell transplantation |
| first_indexed | 2024-04-12T05:38:43Z |
| format | Article |
| id | doaj.art-59c064ba99fc4d6190ed8142344d6b6b |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-04-12T05:38:43Z |
| publishDate | 2019-12-01 |
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| series | Cancer Management and Research |
| spelling | doaj.art-59c064ba99fc4d6190ed8142344d6b6b2022-12-22T03:45:45ZengDove Medical PressCancer Management and Research1179-13222019-12-01Volume 11101951020350219Decitabine-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Intermediate- and High-Risk Myelodysplastic Syndrome/Acute Myeloid Leukemia: Potential Decrease in the Incidence of Acute Graft versus Host DiseaseWang QYLi YLiang ZYYin YLiu WWang QDong YJSun YHXu WLRen HYQing Ya Wang,* Yuan Li,* Ze Yin Liang, Yue Yin, Wei Liu, Qian Wang, Yu Jun Dong, Yu Hua Sun, Wei Lin Xu, Han Yun Ren Department of Hematology, Peking University First Hospital, Peking University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuan Li; Han Yun RenDepartment of Hematology, Peking University First Hospital, Peking University, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, People’s Republic of ChinaTel +86 1083575746; +86 1083575680Email drliyuan75@163.com; renhy0813@163.comPurpose: To evaluate the role of Decitabine in the allo-HSCT conditioning regimen for intermediate- and high-risk patients with MDS or AML.Patients and methods: Retrospective analysis of data pertaining to 76 intermediate- and high-risk patients with MDS or AML who underwent allo-HSCT between December 2005 and June 2018 at the Peking University First Hospital. Forty patients received Decitabine-containing conditioning regimen before transplantation, while thirty-six patients received regimen without Decitabine.Results: Over a median follow-up of 40 months (range, 1 to 155), the cumulative incidence of grade II to IV acute graft versus host disease was 12.4% [95% confidence interval (CI) 4.9–30.9%] in the Decitabine group and 41.5% (95% CI 28.1–61.2%) in the non-Decitabine group (P=0.005). On multivariate analysis, Decitabine-containing conditioning regimen was found to protect against grade II to IV aGVHD (HR=0.279, 95% CI 0.102–0.765, P=0.013). Incidence of respiratory infection in the Decitabine and non-Decitabine groups was 22.5% and 52.78%, respectively (P=0.012). No significant between-group difference was observed with respect to 3-year OS, DFS, or RR (P=0.980, 0.959, and 0.573, respectively), while the median relapse time was longer in the Decitabine group [7 months (range, 2–12) versus 3 months (range, 2–4), P=0.171]. Decitabine-containing conditioning showed a tendency for lower relapse rate among higher risk patients, as assessed by IPSS R; however, the between-group difference was not statistically significant (P=0.085).Conclusion: Inclusion of Decitabine in the conditioning regimen for allo-HSCT in intermediate- and high-risk patients may lower the incidence of aGVHD and respiratory infections, and contribute to longer median relapse time.Keywords: myelodysplastic syndrome, acute myeloid leukemia, Decitabine, transplantation conditioning, graft versus host disease, allogeneic hematopoietic stem cell transplantationhttps://www.dovepress.com/decitabine-containing-conditioning-regimen-for-allogeneic-hematopoieti-peer-reviewed-article-CMARmyelodysplastic syndromeacute myeloid leukemiadecitabinetransplantation conditioninggraft versus host diseaseallogeneic hematopoietic stem cell transplantation. |
| spellingShingle | Wang QY Li Y Liang ZY Yin Y Liu W Wang Q Dong YJ Sun YH Xu WL Ren HY Decitabine-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Intermediate- and High-Risk Myelodysplastic Syndrome/Acute Myeloid Leukemia: Potential Decrease in the Incidence of Acute Graft versus Host Disease Cancer Management and Research myelodysplastic syndrome acute myeloid leukemia decitabine transplantation conditioning graft versus host disease allogeneic hematopoietic stem cell transplantation. |
| title | Decitabine-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Intermediate- and High-Risk Myelodysplastic Syndrome/Acute Myeloid Leukemia: Potential Decrease in the Incidence of Acute Graft versus Host Disease |
| title_full | Decitabine-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Intermediate- and High-Risk Myelodysplastic Syndrome/Acute Myeloid Leukemia: Potential Decrease in the Incidence of Acute Graft versus Host Disease |
| title_fullStr | Decitabine-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Intermediate- and High-Risk Myelodysplastic Syndrome/Acute Myeloid Leukemia: Potential Decrease in the Incidence of Acute Graft versus Host Disease |
| title_full_unstemmed | Decitabine-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Intermediate- and High-Risk Myelodysplastic Syndrome/Acute Myeloid Leukemia: Potential Decrease in the Incidence of Acute Graft versus Host Disease |
| title_short | Decitabine-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Intermediate- and High-Risk Myelodysplastic Syndrome/Acute Myeloid Leukemia: Potential Decrease in the Incidence of Acute Graft versus Host Disease |
| title_sort | decitabine containing conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with intermediate and high risk myelodysplastic syndrome acute myeloid leukemia potential decrease in the incidence of acute graft versus host disease |
| topic | myelodysplastic syndrome acute myeloid leukemia decitabine transplantation conditioning graft versus host disease allogeneic hematopoietic stem cell transplantation. |
| url | https://www.dovepress.com/decitabine-containing-conditioning-regimen-for-allogeneic-hematopoieti-peer-reviewed-article-CMAR |
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