Contributions
Abstract: EP1268
Type: E-Poster Presentation
Session title: Stem cell transplantation - Clinical
Background
Allogeneic stem-cell transplantation (allo-HSCT) is the only curative treatment in myelodysplastic syndromes (MDS) and MDS/myeloproliferative neoplasm (MPN). Post-HSCT relapse remains a major cause of treatment failure.
Aims
In our retrospective group, the addition of a 5-day schedule of decitabine conditioning regimen was proven to be feasible and effective.
Methods
We conducted a multicenter study to prospectively evaluate the feasibility of allo-HSCT with conditioning regimen of 5-day decitabine in 61 patients with a MDS, 6 with chronic myelomonocytic leukemia (CMML), and 9 with secondary acute myeloid leukemia (sAML) after MDS or CMML. Patients received Dec 20 mg/m2/day on days -9 to -5, combined with a Bu/Cy/ Flu/ Ara-c modified preparative regimen.
Results
At a median follow-up of 563 (range: 8-1265) days, the overall survival (OS) was 82.9±4.5%, relapse incidence was 7.9±3.4%, and non-relapse mortality was 13.1±4.1%. Transplant related mortality(TRM) was assessed at 13% on the whole cohort. 6.5% has no engraftment for a total of 5 patients. A neutrophil count of >0.5 × 109/L was achieved at a median of 12 days (range, 6–21 days) and a platelet count of >20 × 109/L within 16 days (10–103 days) post-transplant. The incidence of severe acute (grade III/IV) graft-versus-host disease (GVHD) was 25.0% and that of chronic GVHD was 26.4%. At 2 years, OS was 78.8%,91.7% and 87.5%, respectively, for MDS patients with high risk, very high risk and sAML. Survival was promising in patients with poor-risk mutations, such as TP53 and ASXL1 (76.0%), and in those with ≥3 gene mutations (87.1%).
Conclusion
This new regimen was associated with a low relapse rate, low incidence and severity of GVHD, and satisfactory survival for allo-HSCT patients with MDS and MDS/MPN.
Keyword(s): Allogeneic hematopoietic stem cell transplant, Decitabine, MDS
Abstract: EP1268
Type: E-Poster Presentation
Session title: Stem cell transplantation - Clinical
Background
Allogeneic stem-cell transplantation (allo-HSCT) is the only curative treatment in myelodysplastic syndromes (MDS) and MDS/myeloproliferative neoplasm (MPN). Post-HSCT relapse remains a major cause of treatment failure.
Aims
In our retrospective group, the addition of a 5-day schedule of decitabine conditioning regimen was proven to be feasible and effective.
Methods
We conducted a multicenter study to prospectively evaluate the feasibility of allo-HSCT with conditioning regimen of 5-day decitabine in 61 patients with a MDS, 6 with chronic myelomonocytic leukemia (CMML), and 9 with secondary acute myeloid leukemia (sAML) after MDS or CMML. Patients received Dec 20 mg/m2/day on days -9 to -5, combined with a Bu/Cy/ Flu/ Ara-c modified preparative regimen.
Results
At a median follow-up of 563 (range: 8-1265) days, the overall survival (OS) was 82.9±4.5%, relapse incidence was 7.9±3.4%, and non-relapse mortality was 13.1±4.1%. Transplant related mortality(TRM) was assessed at 13% on the whole cohort. 6.5% has no engraftment for a total of 5 patients. A neutrophil count of >0.5 × 109/L was achieved at a median of 12 days (range, 6–21 days) and a platelet count of >20 × 109/L within 16 days (10–103 days) post-transplant. The incidence of severe acute (grade III/IV) graft-versus-host disease (GVHD) was 25.0% and that of chronic GVHD was 26.4%. At 2 years, OS was 78.8%,91.7% and 87.5%, respectively, for MDS patients with high risk, very high risk and sAML. Survival was promising in patients with poor-risk mutations, such as TP53 and ASXL1 (76.0%), and in those with ≥3 gene mutations (87.1%).
Conclusion
This new regimen was associated with a low relapse rate, low incidence and severity of GVHD, and satisfactory survival for allo-HSCT patients with MDS and MDS/MPN.
Keyword(s): Allogeneic hematopoietic stem cell transplant, Decitabine, MDS