Wang Qing-Yun, Liang Ze-Yin, Dong Yu-Jun, Yin Yue, Wang Qian, Liu Wei, Xu Wei-Lin, Li Yuan, Ren Han-Yun
Department of Hematology，The First Hospital of Peking University，Beijing 100034，China.
Department of Hematology，The First Hospital of Peking University，Beijing 100034，China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Feb;28(1):248-254. doi: 10.19746/j.cnki.issn.1009-2137.2020.01.042.
To investigate the therapeutic efficacy of using decitabine as maintenance therapy for patients with relapsed MDS/AML and as prophylactic therapy for patients with high-risk AML after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Clinical data of 10 patients with MDS/AML from November 2016 to May 2018 were analyzed retrospectively. Among 10 patients there were 4 cases of AML, 2 cases of MDS, and 4 cases of AML transformed from MDS (t-AML). The 10 patients were devided into 2 groups: the relapsed group (n=8) and the prophylactic group (n=2). In relapsed group the decitabine was used as maintenance therapy after achieved complete remission (CR) with decitabine chemotherapy. In prophylactic group the decitabine was used as prophylactic therapy if the patients didn't appear the symptom of graft-versus- host-disease (GVHD) during 30 to 45 d after allo-HSCT. Eight patients received G-CSF-mobilized donor lymphocyte infusion (DLI). The dosage of decitabine for maintenance therapy and prophylactic therapy was 5 mg/m for 7 to 10 days every 4 to 6 weeks, as 1 cycle, amount to 3 to 7 cycles. The dosage was adjusted by the endurance of patients.
Until Nov 30, 2018, 7 out of 10 patients survived. The average survival time was 15.5±1.9 months. 1-year OS rate was 64.0%. Six patients appeared aGVHD, and four patients appeared cGVHD.
The usage of decitabine combined with DLI in patients with relapsed MDS/AML and high-risk AML after allo-HSCT can prolong lives of patients, reduce relapsed rate, and provide the probability for long time survival.
探讨地西他滨作为复发的骨髓增生异常综合征/急性髓系白血病（MDS/AML）患者的维持治疗以及异基因造血干细胞移植（allo-HSCT）后高危AML患者的预防性治疗的疗效。
回顾性分析2016年11月至2018年5月期间10例MDS/AML患者的临床资料。10例患者中，急性髓系白血病（AML）4例，骨髓增生异常综合征（MDS）2例，MDS转化的AML（t-AML）4例。10例患者分为2组：复发组（n = 8）和预防组（n = 2）。复发组在接受地西他滨化疗达到完全缓解（CR）后，用地西他滨作为维持治疗。预防组在allo-HSCT后30至45天内未出现移植物抗宿主病（GVHD）症状时，用地西他滨作为预防性治疗。8例患者接受了粒细胞集落刺激因子（G-CSF）动员的供者淋巴细胞输注（DLI）。维持治疗和预防性治疗地西他滨的剂量均为5mg/m²，每4至6周连用7至10天，作为1个周期，共3至7个周期。剂量根据患者耐受情况调整。
至2018年11月30日，10例患者中7例存活。平均生存时间为15.5±1.9个月。1年总生存率为64.0%。6例患者出现急性移植物抗宿主病（aGVHD），4例患者出现慢性移植物抗宿主病（cGVHD）。
地西他滨联合DLI用于复发的MDS/AML患者及allo-HSCT后的高危AML患者，可延长患者生命，降低复发率，提供长期生存的机会。
