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Bridging-to-transplant with azacitidine for myelodysplastic syndrome and acute myeloid leukemia, reduces the incidence of acute graft-versus-host disease

Koichi Murakami, Hironori Ueno, Takashi Okabe, Toshiya Kagoo, Saigen Boku, Takahiro Yano, Akihiro Yokoyama
  • Koichi Murakami
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
  • Hironori Ueno
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
  • Takashi Okabe
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
  • Toshiya Kagoo
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
  • Saigen Boku
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
  • Takahiro Yano
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
  • Akihiro Yokoyama
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan | ayokoyama@ntmc-hosp.jp

Abstract

Allogeneic stem cell transplantation (allo-SCT) is the only curative option for myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Azacitidine (AZA) has a good toxicity profile compared with intensive chemotherapy and can be considered a pre-transplant regimen in elderly patients and in patients with comorbidities. To investigate the impact of pre-transplant AZA on patient outcome after allo-SCT, we conducted a retrospective analysis of AZA pre-treatment followed by allo-SCT in patients with high-risk MDS and AML. Twenty patients who were divided into two groups according to AZA treatment given prior to allo-SCT (AZA vs non- AZA group, 10 each). Overall survival, event-free survival and incidence of chronic graft-versus-host disease (GVHD) were not significantly different between the two groups. The overall incidence of grade II to IV acute GVHD in the AZA group was significantly lower than that in the non-AZA group (P=0.004). Bridging to transplant with AZA should be considered as an immunomodulator and effective treatment strategy for patients with MDS and AML.

Keywords

azacitidine; bridging to transplan; immunomodulater; acute GVHD

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Submitted: 2017-03-05 11:08:38
Published: 2017-06-15 09:27:08
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Copyright (c) 2017 Akihiro Yokoyama, Koichi Murakami, Hironori Ueno, Takashi Okabe, Toshiya Kagoo, Saigen Boku, Takahiro Yano

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