title: Successful treatment of relapsed AML after allogeneic stem cell transplantation with azacitidine.
abstract: Therapeutic options for patients with relapse of MDS or high risk AML after allogeneic stem cell transplantation are limited. We here present the case of a 64-year-old female patient with MDS, who received peripheral blood stem cells from her HLA-identical brother after a non-myeloablative conditioning regimen. Two months after allogeneic transplantation she suffered from a relapse, now fulfilling WHO criteria for AML with a bone marrow blast count of 91%. We then decided to treat her with azacitidine, a DNA methyltransferase inhibitor with proven antileukemic activity. The patient achieved a complete haematological response after two cycles and full donor chimerism after a single dose of donor lymphocytes. We postulate that azacitidine acts through a direct reduction of malignant cells and may in addition augment the immunologic effects of donor lymphocyte infusions.
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany. graef@med.uni-duesseldorf.de
authors.forename: Thorsten
authors.initials: T
authors.lastname: Graef
authors.forename: Andrea
authors.initials: A
authors.lastname: Kuendgen
authors.forename: Roland
authors.initials: R
authors.lastname: Fenk
authors.forename: Fabian
authors.initials: F
authors.lastname: Zohren
authors.forename: Rainer
authors.initials: R
authors.lastname: Haas
authors.forename: Guido
authors.initials: G
authors.lastname: Kobbe
mesh_terms: D000208:Acute Disease; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001374:Azacitidine / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007951:Leukemia, Myeloid / Q000628:therapy*; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D033581:Stem Cell Transplantation; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001374:Azacitidine