Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial.
Summary of "Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial."
This study evaluated azacitidine as treatment of minimal residual disease (MRD) determined by a sensitive donor chimerism analysis of CD34(+) blood cells to pre-empt relapse in patients with CD34(+) myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT). At a median of 169 days after HSCT, 20/59 prospectively screened patients experienced a decrease of CD34(+) donor chimerism to <80% and received four azacitidine cycles (75 mg/m(2)/day for 7 days) while in complete hematologic remission. A total of 16 patients (80%) responded with either increasing CD34(+) donor chimerism to 80% (n=10; 50%) or stabilization (n=6; 30%) in the absence of relapse. Stabilized patients and those with a later drop of CD34(+) donor chimerism to <80% after initial response were eligible for subsequent azacitidine cycles. A total of 11 patients (55%) received a median of 4 (range, 1-11) additional cycles. Eventually, hematologic relapse occurred in 13 patients (65%), but was delayed until a median of 231 days (range, 56-558) after initial decrease of CD34(+) donor chimerism to <80%. In conclusion, pre-emptive azacitidine treatment has an acceptable safety profile and can substantially prevent or delay hematologic relapse in patients with MDS or AML and MRD after allogeneic HSCT.Leukemia advance online publication, 2 September 2011; doi:10.1038/leu.2011.234.
Affiliation
Medical Clinic and Polyclinic I, University Hospital 'Carl Gustav Carus' Technical University of Dresden, Dresden, Germany.
Journal Details
This article was published in the following journal.
Name: Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K
ISSN: 1476-5551
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21886171
- DOI: http://dx.doi.org/10.1038/leu.2011.234
Medical and Biotech [MESH] Definitions
Bloodless Medical And Surgical Procedures
The treatment of patients without the use of allogeneic BLOOD TRANSFUSIONS or blood products.
Expressed Emotion
Frequency and quality of negative emotions, e.g., anger or hostility, expressed by family members or significant others, that often lead to a high relapse rate, especially in schizophrenic patients. (APA, Thesaurus of Psychological Index Terms, 7th ed)
Primaquine
An aminoquinoline that is given by mouth to produce a radical cure and prevent relapse of vivax and ovale malarias following treatment with a blood schizontocide. It has also been used to prevent transmission of falciparum malaria by those returning to areas where there is a potential for re-introduction of malaria. Adverse effects include anemias and GI disturbances. (From Martindale, The Extra Pharmacopeia, 30th ed, p404)
Directly Observed Therapy
A treatment method in which patients are under direct observation when they take their medication or receive their treatment. This method is designed to reduce the risk of treatment interruption and to ensure patient compliance.
Critical Illness
A disease or state in which death is possible or imminent.
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