title: Azacitidine Pre-Treatment Followed by Reduced-Intensity Stem Cell Transplantation in Patients with Higher-Risk Myelodysplastic Syndrome.
abstract: Azacitidine (AZA) is commonly used in patients with myelodysplastic syndrome (MDS). To determine the role of AZA before allogeneic stem cell transplantation (allo-SCT), we conducted a prospective study of AZA pre-treatment followed by allo-SCT in patients with higher-risk MDS. Twenty-one patients who were scheduled for their third to sixth cycle of AZA pre-treatment followed by allo-SCT were enrolled. AZA pre-treatment was interrupted early in 3 patients (14.3%) because of leukaemic transformation or death. The overall response rate to AZA pre-treatment was 57.1%. There were 2 cases of complete remission, 1 case of partial remission, and 9 cases of haematologic improvement. Fourteen patients (66.7%) received the planned allo-SCT and 5 patients were alive at the last follow-up. Three-year progression-free survival (PFS) and 3-year overall survival (OS) in the 14 patients who received allo-SCT were 30.0% (95% CI 3.3-56.7) and 42.9% (95% CI 17.1-68.7), respectively. PFS and OS were not influenced by response to AZA pre-treatment (p > 0.05). In this study, AZA had a role as a bridge therapy to prevent leukaemic transformation prior to selection of a donor for allo-SCT and showed low toxicity. It may be considered in patients with higher-risk MDS.
authors.affiliation: Department of Hematology-Oncolgy, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea.
authors.forename: Jae-Sook
authors.initials: JS
authors.lastname: Ahn
authors.forename: Yeo-Kyeoung
authors.initials: YK
authors.lastname: Kim
authors.forename: Yoo Hong
authors.initials: YH
authors.lastname: Min
authors.forename: June-Won
authors.initials: JW
authors.lastname: Cheong
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Jang
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
authors.forename: In Ho
authors.initials: IH
authors.lastname: Kim
authors.forename: Hwi-Joong
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Hong Ghi
authors.initials: HG
authors.lastname: Lee
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Sohn
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Hawk
authors.initials: H
authors.lastname: Kim
authors.forename: Yoo-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Jong-Ho
authors.initials: JH
authors.lastname: Won
authors.forename: Joo-Seop
authors.initials: JS
authors.lastname: Chung
authors.forename: Yeung Chul
authors.initials: YC
authors.lastname: Mun
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Hyeoung-Joon
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D000964:Antimetabolites, Antineoplastic; D001374:Azacitidine / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000473:pathology / Q000628:therapy; D011446:Prospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate
chemical_list: D000964:Antimetabolites, Antineoplastic; D001374:Azacitidine