Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation

To provide long-term outcome data and predictors for response and survival, we retrospectively analyzed all 151 patients with relapse of myeloid neoplasms after allogeneic hematopoietic stem cell transplantation (allo-HSCT) who were uniformly treated with first-line azacitidine (Aza) salvage therapy...

Descripción completa

Detalles Bibliográficos
Autores principales: Rautenberg, Christina, Bergmann, Anika, Germing, Ulrich, Fischermanns, Caroline, Pechtel, Sabrina, Kaivers, Jennifer, Jäger, Paul, Schuler, Esther, Haas, Rainer, Kobbe, Guido, Schroeder, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464210/
https://www.ncbi.nlm.nih.gov/pubmed/32806572
http://dx.doi.org/10.3390/cancers12082255
_version_ 1783577311589695488
author Rautenberg, Christina
Bergmann, Anika
Germing, Ulrich
Fischermanns, Caroline
Pechtel, Sabrina
Kaivers, Jennifer
Jäger, Paul
Schuler, Esther
Haas, Rainer
Kobbe, Guido
Schroeder, Thomas
author_facet Rautenberg, Christina
Bergmann, Anika
Germing, Ulrich
Fischermanns, Caroline
Pechtel, Sabrina
Kaivers, Jennifer
Jäger, Paul
Schuler, Esther
Haas, Rainer
Kobbe, Guido
Schroeder, Thomas
author_sort Rautenberg, Christina
collection PubMed
description To provide long-term outcome data and predictors for response and survival, we retrospectively analyzed all 151 patients with relapse of myeloid neoplasms after allogeneic hematopoietic stem cell transplantation (allo-HSCT) who were uniformly treated with first-line azacitidine (Aza) salvage therapy at our center. Patients were treated for molecular (39%) or hematologic relapse (61%), with a median of 5 cycles of Aza and at least one donor lymphocyte infusion in 70% of patients. Overall response was 46%, with 41% achieving complete (CR) and 5% achieving partial remission. CR was achieved after a median of 4 cycles and lasted for a median of 11 months (range 0.9 to 120 months). With a median follow-up of 22 months (range: 1 to 122 months), the 2-year survival rate was 38% ± 9%, including 17 patients with ongoing remission for >5 years. Based on results from multivariate analyses, molecular relapse and time to relapse were integrated into a score, clearly dividing patients into 3 subgroups with CR rates of 71%, 39%, and 29%; and 2-year survival rates of 64%, 38%, and 27%, respectively. In the subgroup of MDS and secondary AML, receiving upfront transplantation was associated with superior response and survival, and therefore pretransplant strategy was integrated together with relapse type into a MDS–sAML-specific score. Overall, Aza enables meaningful responses and long-term survival, which is a predictable with a simple-to-use scoring system.
format Online
Article
Text
id pubmed-7464210
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-74642102020-09-04 Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation Rautenberg, Christina Bergmann, Anika Germing, Ulrich Fischermanns, Caroline Pechtel, Sabrina Kaivers, Jennifer Jäger, Paul Schuler, Esther Haas, Rainer Kobbe, Guido Schroeder, Thomas Cancers (Basel) Article To provide long-term outcome data and predictors for response and survival, we retrospectively analyzed all 151 patients with relapse of myeloid neoplasms after allogeneic hematopoietic stem cell transplantation (allo-HSCT) who were uniformly treated with first-line azacitidine (Aza) salvage therapy at our center. Patients were treated for molecular (39%) or hematologic relapse (61%), with a median of 5 cycles of Aza and at least one donor lymphocyte infusion in 70% of patients. Overall response was 46%, with 41% achieving complete (CR) and 5% achieving partial remission. CR was achieved after a median of 4 cycles and lasted for a median of 11 months (range 0.9 to 120 months). With a median follow-up of 22 months (range: 1 to 122 months), the 2-year survival rate was 38% ± 9%, including 17 patients with ongoing remission for >5 years. Based on results from multivariate analyses, molecular relapse and time to relapse were integrated into a score, clearly dividing patients into 3 subgroups with CR rates of 71%, 39%, and 29%; and 2-year survival rates of 64%, 38%, and 27%, respectively. In the subgroup of MDS and secondary AML, receiving upfront transplantation was associated with superior response and survival, and therefore pretransplant strategy was integrated together with relapse type into a MDS–sAML-specific score. Overall, Aza enables meaningful responses and long-term survival, which is a predictable with a simple-to-use scoring system. MDPI 2020-08-12 /pmc/articles/PMC7464210/ /pubmed/32806572 http://dx.doi.org/10.3390/cancers12082255 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rautenberg, Christina
Bergmann, Anika
Germing, Ulrich
Fischermanns, Caroline
Pechtel, Sabrina
Kaivers, Jennifer
Jäger, Paul
Schuler, Esther
Haas, Rainer
Kobbe, Guido
Schroeder, Thomas
Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation
title Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation
title_full Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation
title_fullStr Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation
title_full_unstemmed Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation
title_short Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation
title_sort prediction of response and survival following treatment with azacitidine for relapse of acute myeloid leukemia and myelodysplastic syndromes after allogeneic hematopoietic stem cell transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464210/
https://www.ncbi.nlm.nih.gov/pubmed/32806572
http://dx.doi.org/10.3390/cancers12082255
work_keys_str_mv AT rautenbergchristina predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT bergmannanika predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT germingulrich predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT fischermannscaroline predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT pechtelsabrina predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT kaiversjennifer predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT jagerpaul predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT schuleresther predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT haasrainer predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT kobbeguido predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation
AT schroederthomas predictionofresponseandsurvivalfollowingtreatmentwithazacitidineforrelapseofacutemyeloidleukemiaandmyelodysplasticsyndromesafterallogeneichematopoieticstemcelltransplantation