Titre :

Single-agent 5-azacytidine as post-transplant maintenance in high-risk myeloid malignancies undergoing allogeneic hematopoietic cell transplantation

Auteur(s) :

Wattebled, Kevin-James [Auteur]
Drumez, Elodie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Coiteux, Valerie [Auteur]
Magro, Leonardo [Auteur]
Srour, Micha [Auteur]
Chauvet, Paul [Auteur]
Quesnel, Bruno [Auteur]
Miniaturisation pour la Synthèse, l’Analyse et la Protéomique - UAR 3290 [MSAP]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Beauvais, David [Auteur]

Titre de la revue :

Annals of Hematology

Date de publication :

2022-03-29

ISSN :

1432-0584

Mot(s)-clé(s) :

Stem cell transplantation
Maintenance therapy
Acute myeloid leukemia
5-azacytidine
Myelodysplastic syndrome

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Relapse is a major cause of treatment failure after allogeneic hematopoietic cell transplantation (allo-HCT) in myeloid malignancies. Additional strategies have been devised to further maximize the immunologic effect of ...
Lire la suite >Relapse is a major cause of treatment failure after allogeneic hematopoietic cell transplantation (allo-HCT) in myeloid malignancies. Additional strategies have been devised to further maximize the immunologic effect of allo-HCT, notably through maintenance therapy with hypomethylating agents such as 5-azacytidine (AZA). We conducted a single-center retrospective study to investigate the efficacy of AZA after allo-HCT for high-risk myeloid malignancies. All patients transplanted between Jan 2014 and Sept 2019 for high-risk acute myeloid leukemia (n = 123), myelodysplastic syndrome (n = 51), or chronic myelomonocytic leukemia (n = 11) were included. Patients who died, relapsed, or developed grade >/= 2 acute graft-versus-host disease before day + 60 were excluded, as well as those who were eligible for anti-FMS-like tyrosine kinase 3 maintenance. Of the 185 included patients, 65 received AZA while 120 did not. Median age at transplant was 59 years; 51.9% of patients were males. The median follow-up was 24 months for both groups. Regarding main patient characteristics and transplantation modalities, the two groups were comparable. In multivariate analyses, there were no significant differences between the two groups in terms of 2-year cumulative incidence of relapse (HR = 1.19; 95% confidence interval (CI) 0.67-2.12; p = 0.55), overall survival (HR = 0.62; 95%CI 0.35-1.12; p = 0.12) and event-free survival (HR = 0.97; 95%CI 0.60-1.58; p = 0.91) rates. In conclusion, single-agent AZA does not appear to be an optimal drug for preventing post-transplant relapse in patients with high-risk myeloid malignancies. This study highlights the need for prospective studies of alternative therapies or combination approaches in the post-transplant setting.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Collections :

• Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290

Source :

Harvested from HAL