Azacitidine Pre-Treatment Followed by Reduced-Intensity Stem Cell Transplantation in Patients with Higher-Risk Myelodysplastic Syndrome

作者：Ahn Jae Sook; Kim Yeo Kyeoung; Min Yoo Hong; Cheong June Won; Jang Jun Ho; Jung Chul Won; Kim In Ho; Yoon Hwi Joong; Lee Hong Ghi; Sohn Sang Kyun; Moon Joon Ho; Kim Hawk; Kim Yoo Jin; Won Jong Ho; Chung Joo Seop; Mun Yeung Chul; Lee Je Hwan; Kim Hyeoung Joon^*

来源：Acta Haematologica, 2015, 134(1): 40-48.

DOI：10.1159/000368711

• Myelodysplastic syndrome
• Azacitidine
• Allogeneic stem cell transplantation

Azacitidine (AZA) is commonly used in patients with myelo-dysplastic syndrome (MDS). To determine the role of AZA before allogeneic stem cell transplantation (allo-SCT), we conducted a prospective study of AZA pre-treatment followed by allo-SCT in patients with higher-risk MDS. Twentyone patients who were scheduled for their third to sixth cycle of AZA pre-treatment followed by allo-SCT were enrolled. AZA pre-treatment was interrupted early in 3 patients (14.3%) because of leukaemic transformation or death. The overall response rate to AZA pre-treatment was 57.1%. There were 2 cases of complete remission, 1 case of partial remission, and 9 cases of haematologic improvement. Fourteen patients (66.7%) received the planned allo-SCT and 5 patients were alive at the last follow-up. Three-year progression-free survival (PFS) and 3-year overall survival (OS) in the 14 patients who received allo-SCT were 30.0% (95% CI 3.3-56.7) and 42.9% (95% CI 17.1-68.7), respectively. PFS and OS were not influenced by response to AZA pre-treatment (p > 0.05). In this study, AZA had a role as a bridge therapy to prevent leukaemic transformation prior to selection of a donor for allo-SCT and showed low toxicity. It may be considered in patients with higher-risk MDS.

• 出版日期2015