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Low-dose azacitidine after allogeneic stem cell transplantation for acute leukemia.

Author(s): Jabbour E, Giralt S, Kantarjian H, Garcia-Manero G, Jagasia M, Kebriaei P, de Padua L, Shpall EJ, Champlin R, de Lima M

Affiliation(s): Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.

Publication date & source: 2009-05-01, Cancer., 115(9):1899-905.

BACKGROUND:: The authors hypothesized that low doses of the hypomethylating agent 5-azacitidine may maximize the graft-versus-leukemia effect and may be tolerated well after allogeneic transplantation (HSCT). METHODS:: The drug was given to 17 patients with acute leukemia as salvage for disease recurrence after HSCT (n = 9 patients) or as maintenance therapy (n = 8 patients). 5-Azacitidine was given subcutaneously daily for 5 days and was repeated every 4 weeks at doses of 16 mg/m(2) (n = 4 patients), 24 mg/m(2) (n = 9 patients), and 40 mg/m(2) (n = 4 patients). A median of 8 cycles was delivered. The median follow-up was 16 months and 11 months after HSCT and 5-azacitidine treatment, respectively. RESULTS:: Five of 9 patients with recurrent disease responded. Four of 13 responding patients developed disease recurrence while they were receiving 5-azacitidine after a median of 10 months. The actuarial 1-year event-free and overall survival rates were 55% and 90%, respectively. There were no extramedullary toxicities, and no graft-versus-host disease exacerbation was observed. CONCLUSIONS:: Low-dose 5-azacitidine may induce durable remissions for patients who develop disease recurrence after HSCT. Further follow-up and a larger group of patients will be necessary to confirm these observations. Cancer 2009. (c) 2009 American Cancer Society.

Page last updated: 2009-10-20

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