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Azacitidine and donor lymphocyte infusions as first salvage therapy for relapse of AML or MDS after allogeneic stem cell transplantation.
MedLine Citation:
PMID:  23314834     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The combination of azacitidine and donor lymphocyte infusions (DLI) as first salvage therapy for relapse after allogeneic transplantation (allo-HSCT) was studied in 30 patients with AML (n=28) or MDS (n=2) within a prospective single-arm multicenter phase-II trial. Treatment schedule contained up to 8 cycles azacitidine (100 mg/m(2)/d, d1-5, every 28d) followed by DLI (1-5 × 10(6)-1-5 × 10(8) CD3(+)cells/kg) after every second azacitidine cycle. A median of 3 courses azacitidine (range 1-8) were administered, and 22 patients (73%) received DLI. Overall response rate was 30% including 7 complete remissions (CR, 23%) and 2 partial remissions (7%). Five patients remain in CR for a median of 777 days (range 461-888). Patients with MDS or AML with myelodysplasia-related changes were more likely to respond (p=0.011) and a lower blast count (p=0.039) as well as high-risk cytogenetics (p=0.035) correlated with the likelihood to achieve CR. Incidence of acute and chronic GvHD was 37% and 17%, respectively. Neutropenia and thrombocytopenia grade III/IV occurred during 65% and 63% of treatment cycles, while infections were the most common grade III/IV non-hematological toxcity. Azacitidine and DLI as salvage therapy is safe, induces long-term remissions and may become an alternative for patients with AML or MDS relapsing after allo-HSCT.Leukemia accepted article preview online, 14 January 2013; doi:10.1038/leu.2013.7.
Authors:
T Schroeder; A Czibere; U Platzbecker; G Bug; L Uharek; T Luft; A Giagounidis; F Zohren; I Bruns; C Wolschke; K Rieger; R Fenk; U Germing; R Haas; N Kröger; G Kobbe
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-14
Journal Detail:
Title:  Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K     Volume:  -     ISSN:  1476-5551     ISO Abbreviation:  Leukemia     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704895     Medline TA:  Leukemia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University of Duesseldorf, Medical Faculty, Duesseldorf, Germany.
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