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Effects of post-transplant maintenance therapy with decitabine prophylaxis on the relapse for acute lymphoblastic leukemia

Bone Marrow Transplantation volume 58, pages 687–695 (2023)Cite this article

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Abstract

In adults with acute lymphoblastic leukemia (ALL), post-transplant relapse is a major risk factor for mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Our study investigated the efficacy and safety of decitabine (dec) with ALL patients post-transplantation. We performed a retrospective cohort study to assess the efficacy of decitabine (dec) with post-transplant ALL at the First Affiliated Hospital of Zhengzhou University from February 2016 to September 2021. A total of 141 consecutive ALL patients were analyzed and divided into decitabine (dec, n = 65) and control (ctrl, n = 76) groups based on whether they were treated with decitabine after allo-HSCT. The 3-year cumulative incidence of relapse (CIR) rate in the dec group was lower than that in the ctrl group (19.6 vs. 36.1%, p = 0.031), with a hazard ratio of 0.491 (95% confidence interval [CI], 0.257–0.936). Additionally, subgroup analyses revealed that the 3-year CIR rate of T-ALL and Ph-negative B-ALL patients in the dec and ctrl groups was 11.7 vs. 35.9% and 19.5 vs. 42.2% (p = 0.035, p = 0.068) respectively. In summary, ALL patients, especially those with T-ALL and Ph-negative B-ALL, may benefit from decitabine as maintenance therapy following allo-HSCT.

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Fig. 1: Maintenance therapy and outcomes in decitabine group.
Fig. 2: Cumulative incidence of relapse in decitabine and control group.
Fig. 3: OS and DFS in decitabine and control group.
Fig. 4: Cumulative incidence of GVHD in decitabine and control group.

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Data availability

The data that support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

This work was supported by Natural Science Foundation of Henan Province (182300410301), Medical Science and Technology Research Project of Henan Province (SBGJ202102147, SBGJ202003036, 2018020118), Science and Technology Plan of Henan Province (182102310160), Project of Higher Education of Henan Province (18A320050).

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  1. These authors contributed equally: Jixin Fan, Runqing Lu, Jingkui Zhu.

Authors and Affiliations

  1. Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Jixin Fan, Runqing Lu, Jingkui Zhu, Dingming Wan, Xinsheng Xie, Weijie Cao, Yinyin Zhang, Haiqiu Zhao, Yingmei Li, Rongqun Guo, Zhongxing Jiang, Yongping Song & Rong Guo

  2. School of Materials and Chemical Engineering, Zhengzhou University, Zhengzhou, China

    Xiao Guo

  3. Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Fei He

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RG, FH and YS designed the protocol. JF, RL and JZ searched databases and drafted the manuscript. JF and XG carried out the statistical analysis. JF and RL revised the final manuscript. All authors critically reviewed and provided final approval for submission.

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Correspondence to Yongping Song, Fei He or Rong Guo.

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Fan, J., Lu, R., Zhu, J. et al. Effects of post-transplant maintenance therapy with decitabine prophylaxis on the relapse for acute lymphoblastic leukemia. Bone Marrow Transplant 58, 687–695 (2023). https://doi.org/10.1038/s41409-023-01948-y

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