Efficiency of 5-azacytidine administration before allogeneic hematopoietic stem cell transplantation in acute myelobastic leukemia, myelodysplastic syndrome, and juvenile myelomonocytic leukemia

Ovechkina, Varvara N.; Bondarenko, Sergej N.; Morozova, Еlena V.; Слесарчук, О. А.; Ekushev, Kirill A.; Zubarovskaya, Ludmila; Afanasyev, Boris

doi:10.18620/ctt-1866-8836-2016-5-3-57-59

Cited by 1 publication

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“…The remaining 34 articles underwent full-length review and 20 of those were excluded for the aforementioned reasons. Ultimately, the eligibility criteria for our meta-analysis were met by 14 studies: two RCTs, two prospective cohort study, and 10 retrospective cohort studies ( 14 – 22 , 25 , 27 – 29 ). Twelve of these compared azacitidine maintenance to observation, whereas two compared decitabine maintenance to observation.…”

Section: Resultsmentioning

confidence: 99%

“…The median time of commencement of the HMAs varied between 56 and 154 days after allo-SCT. Twelve studies used azacitidine ( 14 – 22 , 25 , 27 , 28 ), while two used decitabine ( 24 , 29 ). The azacitidine dosage was 16–50 mg/m 2 on Day 1 to Day 5 every 4 weeks for 1–22 cycles.…”

Section: Resultsmentioning

confidence: 99%

“…Decitabine was administered at 5–20 mg/m 2 on Day 1 to Day 5 every 6–12 weeks for 1–22 cycles. Some patients received prophylactic DLI in addition to HMA maintenance in five studies ( 14 , 18 – 20 , 22 , 27 ).…”

Section: Resultsmentioning

confidence: 99%

“…The OS rates were reported as a 1-year rate in three studies ( 15 – 17 ), a 2-year rate in six studies ( 19 – 22 , 28 , 29 ), and a 3-year rate in three studies ( 14 , 18 , 24 ). The RFS rates were reported as a 1-year rate in two studies ( 15 , 16 ), a 2-year rate in five studies ( 19 – 21 , 27 , 29 ), and a 3-year rate in two studies ( 18 , 24 ).…”

Section: Resultsmentioning

confidence: 99%

“…Many studies have examined the use of azacitidine and decitabine as maintenance after allo-SCT for AML and MDS. Although the majority of the studies supported consideration of HMA maintenance therapy, the remainder did not demonstrate clear benefits ( 14 – 29 ). A recent systematic review explored the safety and efficacy of maintenance treatment following allo-SCT in AML and MDS.…”

Section: Introductionmentioning

confidence: 99%

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Maintenance With Hypomethylating Agents After Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia and Myelodysplastic Syndrome: A Systematic Review and Meta-Analysis

et al. 2022

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IntroductionHypomethylating agents (HMAs) seem to have a range of properties favorable to post-allogeneic hematopoietic stem cell transplantation (allo-SCT) maintenance in acute myeloid leukemia (AML) patients.Materials and MethodsThe Embase, MEDLINE, and Cochrane Central Register of Controlled Trials databases were independently searched by two investigators to identify relevant studies published inception to 18 November 2021. These trials compared HMA maintenance to observation following allo-SCT for AML or myelodysplastic syndrome.ResultsThe meta-analysis eligibility criteria were fulfilled by 14 studies. The overall survival and relapse-free survival of the HMA maintenance group were superior to the observation group, with a pooled risk ratio (RR) of 1.38 and 1.46, respectively. Moreover, the cumulative incidence of relapse was significantly lower in those who received HMAs. The HMA group also had lower non-relapse mortality compared with the observation group. Overall, the incidences of grades III–IV acute graft-vs.-host disease (GVHD) and chronic GVHD did not differ in both groups. However, when looking specifically at those receiving decitabine maintenance, the rate of chronic GVHD seemed to be lower compared with observation alone.ConclusionsThe current systematic review and meta-analysis illustrated that AML and MDS patients receiving HMA maintenance after allo-SCT had better outcomes in regards to OS, RFS, NRM, CIR as well as a reduced incidence of chronic GVHD.

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