PURPOSE: To investigate the impact of prior-to-transplantation azacitidine (AZA) on patient outcome after allogeneic stem-cell transplantation (alloSCT) for myelodysplastic syndrome (MDS). PATIENTS AND METHODS: Of the 265 consecutive patients who underwent alloSCT for MDS between October 2005 and December 2009, 163 had received cytoreductive treatment prior to transplantation, including induction chemotherapy (ICT) alone (ICT group; n = 98), AZA alone (AZA group; n = 48), or AZA preceded or followed by ICT (AZA-ICT group; n = 17). At diagnosis, 126 patients (77%) had an excess of marrow blasts, and 95 patients (58%) had intermediate-2 or high-risk MDS according to the International Prognostic Scoring System (IPSS). Progression to more advanced disease before alloSCT was recorded in 67 patients. Donors were sibling (n = 75) or HLA-matched unrelated (10/10; n = 88). They received blood (n = 142) or marrow (n = 21) grafts following either myeloablative (n = 33) or reduced intensity (n = 130) conditioning. RESULTS: With a median follow-up of 38.7 months, 3-year outcomes in the AZA, ICT, and AZA-ICT groups were 55%, 48%, and 32% (P = .07) for overall survival (OS); 42%, 44%, and 29% (P = .14) for event-free survival (EFS); 40%, 37%, and 36% (P = .86) for relapse; and 19%, 20%, and 35% (P = .24) for nonrelapse mortality (NRM), respectively. Multivariate analysis confirmed the absence of statistical differences between the AZA and the ICT groups in terms of OS, EFS, relapse, and NRM. CONCLUSION: With the goal of downstaging underlying disease before alloSCT, AZA alone led to outcomes similar to those for standard ICT.
PURPOSE: To investigate the impact of prior-to-transplantation azacitidine (AZA) on patient outcome after allogeneic stem-cell transplantation (alloSCT) for myelodysplastic syndrome (MDS). PATIENTS AND METHODS: Of the 265 consecutive patients who underwent alloSCT for MDS between October 2005 and December 2009, 163 had received cytoreductive treatment prior to transplantation, including induction chemotherapy (ICT) alone (ICT group; n = 98), AZA alone (AZA group; n = 48), or AZA preceded or followed by ICT (AZA-ICT group; n = 17). At diagnosis, 126 patients (77%) had an excess of marrow blasts, and 95 patients (58%) had intermediate-2 or high-risk MDS according to the International Prognostic Scoring System (IPSS). Progression to more advanced disease before alloSCT was recorded in 67 patients. Donors were sibling (n = 75) or HLA-matched unrelated (10/10; n = 88). They received blood (n = 142) or marrow (n = 21) grafts following either myeloablative (n = 33) or reduced intensity (n = 130) conditioning. RESULTS: With a median follow-up of 38.7 months, 3-year outcomes in the AZA, ICT, and AZA-ICT groups were 55%, 48%, and 32% (P = .07) for overall survival (OS); 42%, 44%, and 29% (P = .14) for event-free survival (EFS); 40%, 37%, and 36% (P = .86) for relapse; and 19%, 20%, and 35% (P = .24) for nonrelapse mortality (NRM), respectively. Multivariate analysis confirmed the absence of statistical differences between the AZA and the ICT groups in terms of OS, EFS, relapse, and NRM. CONCLUSION: With the goal of downstaging underlying disease before alloSCT, AZA alone led to outcomes similar to those for standard ICT.
Authors: Roni Tamari; Stephen S Chung; Esperanza B Papadopoulos; Ann A Jakubowski; Patrick Hilden; Sean M Devlin; Jenna D Goldberg; Miguel-Angel Perales; Doris M Ponce; Craig S Sauter; Molly A Maloy; Dara Y Herman; Virginia Klimek; James W Young; Richard J O'Reilly; Sergio A Giralt; Hugo Castro-Malaspina Journal: Biol Blood Marrow Transplant Date: 2015-07-14 Impact factor: 5.742
Authors: Theo de Witte; David Bowen; Marie Robin; Luca Malcovati; Dietger Niederwieser; Ibrahim Yakoub-Agha; Ghulam J Mufti; Pierre Fenaux; Guillermo Sanz; Rodrigo Martino; Emilio Paolo Alessandrino; Francesco Onida; Argiris Symeonidis; Jakob Passweg; Guido Kobbe; Arnold Ganser; Uwe Platzbecker; Jürgen Finke; Michel van Gelder; Arjan A van de Loosdrecht; Per Ljungman; Reinhard Stauder; Liisa Volin; H Joachim Deeg; Corey Cutler; Wael Saber; Richard Champlin; Sergio Giralt; Claudio Anasetti; Nicolaus Kröger Journal: Blood Date: 2017-01-17 Impact factor: 22.113
Authors: Sa A Wang; Keyur P Patel; Olga Pozdnyakova; Jie Peng; Zhuang Zuo; Paola Dal Cin; David P Steensma; Robert P Hasserjian Journal: Mod Pathol Date: 2016-07-15 Impact factor: 7.842
Authors: B J Trottier; Z Sachs; T E DeFor; L Shune; M Dolan; D J Weisdorf; C Ustun; E D Warlick Journal: Bone Marrow Transplant Date: 2015-11-23 Impact factor: 5.483