Murakami Koichi, Ueno Hironori, Okabe Takashi, Kagoo Toshiya, Boku Saigen, Yano Takahiro, Yokoyama Akihiro
Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Hematol Rep. 2017 Jun 15;9(2):7114. doi: 10.4081/hr.2017.7114. eCollection 2017 Jun 1.
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 non-AZA group, 10 each). Overall survival, event-free survival and incidence of chronic graft--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.
异基因干细胞移植（allo-SCT）是骨髓增生异常综合征（MDS）和急性髓系白血病（AML）的唯一治愈选择。与强化化疗相比，阿扎胞苷（AZA）具有良好的毒性特征，可被视为老年患者和合并症患者的移植前方案。为了研究移植前使用AZA对allo-SCT后患者预后的影响，我们对高危MDS和AML患者在allo-SCT前进行AZA预处理的情况进行了回顾性分析。20例患者根据allo-SCT前给予的AZA治疗分为两组（AZA组和非AZA组，每组10例）。两组患者的总生存期、无事件生存期和慢性移植物抗宿主病（GVHD）发生率无显著差异。AZA组II至IV级急性GVHD的总发生率显著低于非AZA组（P = 0.004）。对于MDS和AML患者，应将使用AZA过渡到移植作为一种免疫调节剂和有效的治疗策略。
