Cargando…

Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia

BACKGROUND: Post-transplant relapse remains a principal leading cause of failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with adult acute lymphoblastic leukemia (ALL). The aim of this study was to investigate the efficacy and safety of low-dose decitabine on...

Descripción completa

Detalles Bibliográficos
Autores principales: Liu, Jia, Jiang, Zhong-Xing, Xie, Xin-Sheng, Wan, Ding-Ming, Cao, Wei-Jie, Wang, Meng, Liu, Zhen-Zhen, Dong, Zhen-Kun, Wang, Hai-Qiong, Lu, Run-Qing, Zhang, Yin-Yin, Cheng, Qian-Qian, Fan, Ji-Xin, Li, Wei, He, Fei, Guo, Rong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415411/
https://www.ncbi.nlm.nih.gov/pubmed/34485147
http://dx.doi.org/10.3389/fonc.2021.710545
_version_ 1783747964617883648
author Liu, Jia
Jiang, Zhong-Xing
Xie, Xin-Sheng
Wan, Ding-Ming
Cao, Wei-Jie
Wang, Meng
Liu, Zhen-Zhen
Dong, Zhen-Kun
Wang, Hai-Qiong
Lu, Run-Qing
Zhang, Yin-Yin
Cheng, Qian-Qian
Fan, Ji-Xin
Li, Wei
He, Fei
Guo, Rong
author_facet Liu, Jia
Jiang, Zhong-Xing
Xie, Xin-Sheng
Wan, Ding-Ming
Cao, Wei-Jie
Wang, Meng
Liu, Zhen-Zhen
Dong, Zhen-Kun
Wang, Hai-Qiong
Lu, Run-Qing
Zhang, Yin-Yin
Cheng, Qian-Qian
Fan, Ji-Xin
Li, Wei
He, Fei
Guo, Rong
author_sort Liu, Jia
collection PubMed
description BACKGROUND: Post-transplant relapse remains a principal leading cause of failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with adult acute lymphoblastic leukemia (ALL). The aim of this study was to investigate the efficacy and safety of low-dose decitabine on the prevention of adult ALL relapse after allo-HSCT. METHODS: In this prospective study, we enrolled 34 patients with ALL who underwent allo-HSCT from August 2016 to April 2020 and received low-dose decitabine maintenance treatment after transplantation. The primary objectives were cumulative incidence of relapse rate (CIR), overall survival (OS), and disease-free survival (DFS). The secondary objectives were graft-versus-host disease (GVHD) and safety. RESULTS: Among the enrolled 34 patients, 6 patients relapsed and 6 patients died. The 2-year CIR, OS, and DFS were 20.2, 77.5, and 73.6%, respectively. Subgroup analysis revealed the 2-year CIR, OS, and DFS rates of 12 patients with T-ALL/lymphoblastic lymphoma (LBL) were 8.3, 90, and 81.5%, respectively. None of the seven patients with T-ALL relapsed. During maintenance treatment, only one patient (2.9%) developed grade IV acute GVHD and four (11.8%) patients had severe chronic GVHD. Thirty-two patients (94.1%) developed only grade I to II myelosuppression, and two patients (5.8%) developed grade III to IV granulocytopenia. CONCLUSIONS: Maintenance treatment with low-dose decitabine after allo-HSCT may be used as a therapeutic option to reduce relapse in patients with adult ALL, especially in patients with T-ALL. Our findings require confirmation in larger-scale controlled trials. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trials Registry, identifier ChiCTR1800014888.
format Online
Article
Text
id pubmed-8415411
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-84154112021-09-04 Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia Liu, Jia Jiang, Zhong-Xing Xie, Xin-Sheng Wan, Ding-Ming Cao, Wei-Jie Wang, Meng Liu, Zhen-Zhen Dong, Zhen-Kun Wang, Hai-Qiong Lu, Run-Qing Zhang, Yin-Yin Cheng, Qian-Qian Fan, Ji-Xin Li, Wei He, Fei Guo, Rong Front Oncol Oncology BACKGROUND: Post-transplant relapse remains a principal leading cause of failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with adult acute lymphoblastic leukemia (ALL). The aim of this study was to investigate the efficacy and safety of low-dose decitabine on the prevention of adult ALL relapse after allo-HSCT. METHODS: In this prospective study, we enrolled 34 patients with ALL who underwent allo-HSCT from August 2016 to April 2020 and received low-dose decitabine maintenance treatment after transplantation. The primary objectives were cumulative incidence of relapse rate (CIR), overall survival (OS), and disease-free survival (DFS). The secondary objectives were graft-versus-host disease (GVHD) and safety. RESULTS: Among the enrolled 34 patients, 6 patients relapsed and 6 patients died. The 2-year CIR, OS, and DFS were 20.2, 77.5, and 73.6%, respectively. Subgroup analysis revealed the 2-year CIR, OS, and DFS rates of 12 patients with T-ALL/lymphoblastic lymphoma (LBL) were 8.3, 90, and 81.5%, respectively. None of the seven patients with T-ALL relapsed. During maintenance treatment, only one patient (2.9%) developed grade IV acute GVHD and four (11.8%) patients had severe chronic GVHD. Thirty-two patients (94.1%) developed only grade I to II myelosuppression, and two patients (5.8%) developed grade III to IV granulocytopenia. CONCLUSIONS: Maintenance treatment with low-dose decitabine after allo-HSCT may be used as a therapeutic option to reduce relapse in patients with adult ALL, especially in patients with T-ALL. Our findings require confirmation in larger-scale controlled trials. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trials Registry, identifier ChiCTR1800014888. Frontiers Media S.A. 2021-08-16 /pmc/articles/PMC8415411/ /pubmed/34485147 http://dx.doi.org/10.3389/fonc.2021.710545 Text en Copyright © 2021 Liu, Jiang, Xie, Wan, Cao, Wang, Liu, Dong, Wang, Lu, Zhang, Cheng, Fan, Li, He and Guo https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Liu, Jia
Jiang, Zhong-Xing
Xie, Xin-Sheng
Wan, Ding-Ming
Cao, Wei-Jie
Wang, Meng
Liu, Zhen-Zhen
Dong, Zhen-Kun
Wang, Hai-Qiong
Lu, Run-Qing
Zhang, Yin-Yin
Cheng, Qian-Qian
Fan, Ji-Xin
Li, Wei
He, Fei
Guo, Rong
Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia
title Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia
title_full Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia
title_fullStr Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia
title_full_unstemmed Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia
title_short Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia
title_sort maintenance treatment with low-dose decitabine after allogeneic hematopoietic cell transplantation in patients with adult acute lymphoblastic leukemia
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415411/
https://www.ncbi.nlm.nih.gov/pubmed/34485147
http://dx.doi.org/10.3389/fonc.2021.710545
work_keys_str_mv AT liujia maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT jiangzhongxing maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT xiexinsheng maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT wandingming maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT caoweijie maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT wangmeng maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT liuzhenzhen maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT dongzhenkun maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT wanghaiqiong maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT lurunqing maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT zhangyinyin maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT chengqianqian maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT fanjixin maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT liwei maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT hefei maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia
AT guorong maintenancetreatmentwithlowdosedecitabineafterallogeneichematopoieticcelltransplantationinpatientswithadultacutelymphoblasticleukemia