Maintenance azacitidine after myeloablative allogeneic hematopoietic cell transplantation for myeloid malignancies. Issue 12 (2nd December 2018)

• Record Type: Journal Article
• Authors: Maples, Kathryn T.; Sabo, Roy T.; McCarty, John M.; Toor, Amir A.; Hawks, Kelly G.
• Is Part Of: Leukemia & lymphoma. Volume 59:Issue 12(2018)
• Page Start: 2836
• Page End: 2841
• Publication Date: 2018-12-02
• Subjects: Acute myeloid leukemia -- myelodysplastic syndrome -- allogeneic transplantation -- maintenance chemotherapy -- azacitidine; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2018.1443334
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Allogeneic hematopoietic cell transplantation (HCT) is a curative option for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), but carries a high risk of relapse. This retrospective review evaluates the effectiveness of maintenance azacitidine in high-risk AML and MDS patients to reduce the probability of relapse. Twenty-five patients who received maintenance azacitidine were matched to historical controls in a two-to-one ratio based on diagnosis, donor type, conditioning regimen intensity, and age. Over 90% of patients received myeloablative conditioning. There was no difference in time to hematologic relapse, overall survival, or non-relapse mortality. Maintenance therapy was stopped early in 72% of patients due to graft-versus-host-disease, relapse, infection, and intolerance (13 of 25 patients received less than 4 cycles). There was a trend towards higher toxicity in the azacitidine group. The use of prophylactic azacitidine following myeloablative allogeneic HCT outside a clinical trial cannot be recommended at this time.