含10天地西他滨预处理方案异基因造血干细胞移植治疗31例急性髓系白血病/骨髓增生异常综合征患者的疗效及安全性

OBJECTIVE: To investigate the early effect and safety of allogeneic hematopoietic stem cell transplantation（allo-HSCT）with a 10-day decitabine-containing conditioning regimen in the treatment of acute myeloid leukemia（AML）/myelodysplastic syndrome (MDS). METHODS: From April 2021 to May 2022, 31 AML/MDS patients who received allo-HSCT with a 10-day decitabine-containing conditioning regimen were analyzed. RESULTS: AML（n＝10）, MDS-AML（n＝6）, CMML-AML（n＝1）, and MDS（n＝14）were identified in 31 patients, 16 males, and 15 females, with a median age of 41（20–55）yr. Neutrophils and platelets were successfully implanted in 31 patients（100％）, with a median implantation duration of 12（9–30）and 14（9–42）days, respectively. During the preconditioning period, 16 patients（51.6％）developed oral mucositis, with 15 cases of Ⅰ/Ⅱ grade（48.4％）and one case of Ⅲ grade（3.2％）. After transplantation, 13 patients（41.9％）developed CMV viremia, six patients（19.4％）developed hemorrhagic cystitis, and four patients（12.9％）developed a local infection. The median time of acute graft versus host disease（aGVHD）following transplantation was 33（12–111）days. The cumulative incidence of aGVHD and Ⅲ/Ⅳ grade aGVHD was 41.9％（95％ CI 26.9％–61.0％）and 22.9％（95％ CI 13.5％–47.5％）, respectively. There was no severe cGVHD, and mild and moderate chronic GVHD（cGVHD）incidence was 23.5％（95％ CI 12.1％–43.6％）. As of November 30, 2022, only one of the 31 patients had relapsed, with a 1-yr cumulative relapse rate（CIR）of 3.2％（95％ CI 0.5％–20.7％）. There was only one relapse patient death and no non-relapse deaths. The 1-yr overall survival（OS）and disease-free survival（DFS）rates were 92.9％（95％ CI 80.3％–100％）and 96.8％（95％ CI 90.8％–100％）, respectively. CONCLUSION: A 10-day decitabine-containing conditioning regimen for allo-HSCT reduced relapse and was safe and feasible in treating AML/MDS.