5-azacytidine as salvage treatment in relapsed myeloid tumors after allogeneic bone marrow transplantation.
Relapse after allogeneic blood or marrow transplantation carries a very poor prognosis. Current strategies for management that include donor lymphocyte infusions (DLIs) and salvage chemotherapies are usually toxic and ineffective. Here we report the outcome of 10 patients with myeloid malignancies that received 5-azacytidine after a failed allogeneic bone marrow transplant. Of the 10 patients, 6 achieved a complete remission, 1 had stable disease, and 3 progressed after a median of 6 cycles administered. Only 1 patient has died (of disease progression), and no flares of graft-versus-host disease (GVHD) were observed with 5-azacytidine. As of latest follow-up, the median overall survival (OS) for the group was 422.5 days (127-1411). These results further suggest that 5-azacytidine is an active agent after failing an allogeneic bone marrow transplant, and prospective studies are warranted.
George W. Santos Bone Marrow Transplant Service, Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland 21231, USA. fbolano2@jhmi.edu
Javier
J
Bolaños-Meade
B Douglas
BD
Smith
Steven D
SD
Gore
Michael A
MA
McDevitt
Leo
L
Luznik
Ephraim J
EJ
Fuchs
Richard J
RJ
Jones
D000328:Adult; D000368:Aged; D001374:Azacitidine / Q000008:administration & dosage* / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D016879:Salvage Therapy / Q000379:methods; D055502:Secondary Prevention; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous
D001374:Azacitidine