Effects of post-transplant maintenance therapy with decitabine prophylaxis on the relapse for acute lymphoblastic leukemia.

Abstract

In adults with acute lymphoblastic leukemia (ALL), post-transplant relapse is a major risk factor for mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Our study investigated the efficacy and safety of decitabine (dec) with ALL patients post-transplantation. We performed a retrospective cohort study to assess the efficacy of decitabine (dec) with post-transplant ALL at the First Affiliated Hospital of Zhengzhou University from February 2016 to September 2021. A total of 141 consecutive ALL patients were analyzed and divided into decitabine (dec, n = 65) and control (ctrl, n = 76) groups based on whether they were treated with decitabine after allo-HSCT. The 3-year cumulative incidence of relapse (CIR) rate in the dec group was lower than that in the ctrl group (19.6 vs. 36.1%, p = 0.031), with a hazard ratio of 0.491 (95% confidence interval [CI], 0.257-0.936). Additionally, subgroup analyses revealed that the 3-year CIR rate of T-ALL and Ph-negative B-ALL patients in the dec and ctrl groups was 11.7 vs. 35.9% and 19.5 vs. 42.2% (p = 0.035, p = 0.068) respectively. In summary, ALL patients, especially those with T-ALL and Ph-negative B-ALL, may benefit from decitabine as maintenance therapy following allo-HSCT.

• Authors: Jixin Fan, Runqing Lu, Jingkui Zhu, Xiao Guo, Dingming Wan, Xinsheng Xie, Weijie Cao, Yinyin Zhang, Haiqiu Zhao, Yingmei Li, Rongqun Guo, Zhongxing Jiang, Yongping Song, Fei He, Rong Guo
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 58 Issue 6 Pg. 687-695 (06 2023) ISSN: 1476-5365 [Electronic] England
• PMID: 36964223 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2023. The Author(s), under exclusive licence to Springer Nature Limited.

Chemical References

• Decitabine

Topics

• Adult
• Humans
• Decitabine (pharmacology, therapeutic use)
• Retrospective Studies
• Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
• Recurrence
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy)
• Acute Disease
• Hematopoietic Stem Cell Transplantation