George W. Santos Bone Marrow Transplant Service, Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland 21231, USA.
Biol Blood Marrow Transplant. 2011 May;17(5):754-8. doi: 10.1016/j.bbmt.2010.10.008. Epub 2010 Oct 15.
Relapse after allogeneic blood or marrow transplantation carries a very poor prognosis. Current strategies for management that include donor lymphocyte infusions (DLIs) and salvage chemotherapies are usually toxic and ineffective. Here we report the outcome of 10 patients with myeloid malignancies that received 5-azacytidine after a failed allogeneic bone marrow transplant. Of the 10 patients, 6 achieved a complete remission, 1 had stable disease, and 3 progressed after a median of 6 cycles administered. Only 1 patient has died (of disease progression), and no flares of graft-versus-host disease (GVHD) were observed with 5-azacytidine. As of latest follow-up, the median overall survival (OS) for the group was 422.5 days (127-1411). These results further suggest that 5-azacytidine is an active agent after failing an allogeneic bone marrow transplant, and prospective studies are warranted.
异基因造血干细胞移植后复发的预后非常差。目前包括供者淋巴细胞输注（DLI）和挽救性化疗在内的治疗策略通常具有毒性且无效。在这里，我们报告了 10 例接受异基因骨髓移植失败后接受 5-氮杂胞苷治疗的骨髓恶性肿瘤患者的结果。在 10 例患者中，6 例达到完全缓解，1 例疾病稳定，3 例在中位数为 6 个周期的治疗后进展。只有 1 例患者（因疾病进展）死亡，并且在使用 5-氮杂胞苷时没有观察到移植物抗宿主病（GVHD）的爆发。截至最新随访，该组的中位总生存期（OS）为 422.5 天（127-1411）。这些结果进一步表明，5-氮杂胞苷是异基因骨髓移植失败后的一种有效药物，需要进行前瞻性研究。
