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Pretransplantation 5-azacitidine in high-risk myelodysplastic syndrome.
- Source :
-
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2014 Jun; Vol. 20 (6), pp. 776-80. Date of Electronic Publication: 2014 Feb 15. - Publication Year :
- 2014
-
Abstract
- We prospectively evaluated the allogeneic hematopoietic cell transplantation (HCT) outcomes in high-risk myelodysplastic syndrome (MDS) patients who received pretransplantation 5-azacitidine. Twenty-five patients evaluated for allogeneic HCT consult and considered medically eligible for a donor search were enrolled. Azacitidine was administered at 75 mg/m(2) for 5 to 7 days every 4 weeks until a suitable donor was found. A median of 3 (range, 0 to 6) cycles of 5-azacitidine were administered. Preallogeneic HCT responses to 5-azacitidine, based on the International Working Group criteria, were 48% partial response, 33% stable disease, and 19% progressive disease. Four patients did not proceed to allogeneic HCT. Twenty-one patients, a median age of 55 (range, 25 to 67) years, received allogeneic HCT after myeloablative pharmacokinetically targeted i.v. busulfan and fludarabine conditioning regimen. Donors were either HLA-matched related or unrelated, except for 1 mismatch unrelated donor. With a median follow-up of 30 months, 1-year relapse-free and overall survivals were 52% (95% confidence interval [CI], 30% to 71%) and 62% (95% CI, 38% to 79%), respectively. Preallogeneic HCT 5-azacitidine administration was well tolerated and provided reasonable disease control before allogeneic HCT. (Registered at ClinicalTrials.gov as NCT00660400).<br /> (Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Combined Modality Therapy
Female
Humans
Male
Middle Aged
Myelodysplastic Syndromes drug therapy
Pilot Projects
Prospective Studies
Tissue Donors
Transplantation Conditioning methods
Transplantation, Homologous
Unrelated Donors
Azacitidine therapeutic use
Hematopoietic Stem Cell Transplantation methods
Myelodysplastic Syndromes therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6536
- Volume :
- 20
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 24534108
- Full Text :
- https://doi.org/10.1016/j.bbmt.2014.02.008