Maintenance therapy for AML after allogeneic HCT

Nayak, Rahul; Chen, Yi-Bin

doi:10.3389/fonc.2022.895771

Cited by 7 publications

(5 citation statements)

References 60 publications

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“…SL-401, a recombinant fusion protein that directly targets the interleukin 3 receptor on the surface of BPDCN cells, has shown moderate efficacy in this disease, but the number of cases is limited, and more convincing prospective randomized controlled trials are needed to validate this finding[ 7 , 8 ]. Bridging allo-HSCT after CR1 with induction consolidation chemotherapy is currently the best option for treating AML and BPDCN[ 9 , 10 ]. By analyzing 15 patients with BPDCN who received allo-HSCT and underwent marrow clearance, Lu et al [ 9 ] found an OS rate of 73.3% ± 10.5%.…”

Section: Discussionmentioning

confidence: 99%

Azacitidine maintenance therapy for blastic plasmacytoid dendritic cell neoplasm allograft: A case report

Tao,

Wen,

Wang

et al. 2024

World J Clin Cases

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BACKGROUND Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, highly invasive malignant neoplasm. There is no universally accepted standard of care because of its rarity and the dearth of prospective research. It is still challenging for some patients to achieve persistent clinical remission or cure, despite the success of allogeneic hematopoietic stem cell transplantation (allo-HSCT), indicating that there is still a significant recurrence rate. We report a case of prevention of BPDCN allograft recurrence by azacitidine maintenance therapy and review the relevant literature. CASE SUMMARY We report a 41-year-old man with BPDCN who was admitted to hospital due to skin sclerosis for > 5 mo’ duration. BPDCN was diagnosed by combined clinical assessment and laboratory examinations. Following diagnosis, the patients underwent induction consolidation chemotherapy to achieve the first complete remission, followed by bridging allo-HSCT. Post-transplantation, azacitidine (75 mg/m2 for 7 d) was administered as maintenance therapy, with repeat administration every 4–6 wk and appropriate extension of the chemotherapy cycle. After 10 cycles, the patient has been disease free for 26 mo after transplantation. Regular assessments of bone marrow morphology, minimal residual disease, full donor chimerism, Epstein–Barr virus, and cytomegalovirus all yielded normal results with no abnormalities detected. CONCLUSION Azacitidine may be a safe and effective maintenance treatment for BPDCN following transplantation because there were no overt adverse events during the course of treatment.

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Section: Discussionmentioning

confidence: 99%

Azacitidine maintenance therapy for blastic plasmacytoid dendritic cell neoplasm allograft: A case report

Tao,

Wen,

Wang

et al. 2024

World J Clin Cases

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“…It has limited utility in the treatment of frank relapse and is more commonly utilized as a preemptive strategy for the emergence of MRD or loss of chimerism. The mechanism of action is based on non-tolerant T cells augmenting the graft-versus-leukemia effect but at the expense of causing GVHD [ 47 ]. Liga et al investigated low-dose prophylactic DLI in 15 patients with acute leukemia treated with an alemtuzumab-containing conditioning regimen.…”

Section: Who Should Receive Post-hct Maintenance Therapy?mentioning

confidence: 99%

“…The regimen was well tolerated but needs validation in larger studies [ 51 ]. The use of prophylactic DLI as monotherapy as well as in combination with chemotherapy is an active area of collaborative prospective trials [ 47 ].…”

Section: Who Should Receive Post-hct Maintenance Therapy?mentioning

confidence: 99%

Post-Transplant Maintenance Therapy in Acute Myeloid Leukemia

Parks,

Aslam,

Kumar

et al. 2024

Cancers

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Allogeneic hematopoietic cell transplantation (allo-HCT) is potentially curative for patients with acute myeloid leukemia (AML). However, the post-transplant relapse rate ranges from 40 to 70%, particularly with reduced intensity conditioning, and remains a major cause of treatment failure for these patients due to the limited efficacy of salvage therapy options. Strategies to mitigate this risk are urgently needed. In the past few years, the basic framework of post-transplant maintenance has been shaped by several clinical trials investigating targeted therapy, chemotherapy, and immunomodulatory therapies. Although the practice of post-transplant maintenance in AML has become more common, there remain challenges regarding the feasibility and efficacy of this strategy. Here, we review major developments in post-transplant maintenance in AML, along with ongoing and future planned studies in this area, outlining the limitations of available data and our future goals.

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“…Prior to HSCT, these agents are used alone or in combination to decrease disease burden and serve as a bridge to transplant, especially in older patients with MDS and AML (74-77). In the posttransplantation period, there is growing interest in strategies that will help prevent relapse, which is a major driver of mortality (77)(78)(79). Preclinical and clinical data suggested that azacitidine may mitigate GVHD without compromising graft-versus-leukemia (GVL) activity (80)(81)(82).…”

Section: Epigenetic Regulation Of Hematopoietic Stem Cells Before And...mentioning

confidence: 99%

The impact of epigenetic modifications on allogeneic hematopoietic stem cell transplantation

et al. 2023

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The field of epigenetics studies the complex processes that regulate gene expression without altering the DNA sequence itself. It is well established that epigenetic modifications are crucial to cellular homeostasis and differentiation and play a vital role in hematopoiesis and immunity. Epigenetic marks can be mitotically and/or meiotically heritable upon cell division, forming the basis of cellular memory, and have the potential to be reversed between cellular fate transitions. Hence, over the past decade, there has been increasing interest in the role that epigenetic modifications may have on the outcomes of allogeneic hematopoietic transplantation and growing enthusiasm in the therapeutic potential these pathways may hold. In this brief review, we provide a basic overview of the types of epigenetic modifications and their biological functions, summarizing the current literature with a focus on hematopoiesis and immunity specifically in the context of allogeneic hematopoietic stem cell transplantation.

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Maintenance therapy for AML after allogeneic HCT

Cited by 7 publications

References 60 publications

Azacitidine maintenance therapy for blastic plasmacytoid dendritic cell neoplasm allograft: A case report

Azacitidine maintenance therapy for blastic plasmacytoid dendritic cell neoplasm allograft: A case report

Post-Transplant Maintenance Therapy in Acute Myeloid Leukemia

The impact of epigenetic modifications on allogeneic hematopoietic stem cell transplantation

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