Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial
This study evaluated azacitidine as treatment of minimal residual disease (MRD) determined by a sensitive donor chimerism analysis of CD34 + blood cells to pre-empt relapse in patients with CD34 + myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) after allogeneic hematopoietic stem cel...
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creator | Platzbecker, U Wermke, M Radke, J Oelschlaegel, U Seltmann, F Kiani, A Klut, I-M Knoth, H Röllig, C Schetelig, J Mohr, B Graehlert, X Ehninger, G Bornhäuser, M Thiede, C |
description | This study evaluated azacitidine as treatment of minimal residual disease (MRD) determined by a sensitive donor chimerism analysis of CD34
+
blood cells to pre-empt relapse in patients with CD34
+
myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT). At a median of 169 days after HSCT, 20/59 prospectively screened patients experienced a decrease of CD34
+
donor chimerism to |
doi_str_mv | 10.1038/leu.2011.234 |
format | Article |
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+
blood cells to pre-empt relapse in patients with CD34
+
myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT). At a median of 169 days after HSCT, 20/59 prospectively screened patients experienced a decrease of CD34
+
donor chimerism to <80% and received four azacitidine cycles (75 mg/m
2
/day for 7 days) while in complete hematologic remission. A total of 16 patients (80%) responded with either increasing CD34
+
donor chimerism to ⩾80% (
n
=10; 50%) or stabilization (
n
=6; 30%) in the absence of relapse. Stabilized patients and those with a later drop of CD34
+
donor chimerism to <80% after initial response were eligible for subsequent azacitidine cycles. A total of 11 patients (55%) received a median of 4 (range, 1–11) additional cycles. Eventually, hematologic relapse occurred in 13 patients (65%), but was delayed until a median of 231 days (range, 56–558) after initial decrease of CD34
+
donor chimerism to <80%. In conclusion, pre-emptive azacitidine treatment has an acceptable safety profile and can substantially prevent or delay hematologic relapse in patients with MDS or AML and MRD after allogeneic HSCT.</description><identifier>ISSN: 0887-6924</identifier><identifier>EISSN: 1476-5551</identifier><identifier>DOI: 10.1038/leu.2011.234</identifier><identifier>PMID: 21886171</identifier><identifier>CODEN: LEUKED</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Adult ; Aged ; Antimetabolites, Antineoplastic - adverse effects ; Antimetabolites, Antineoplastic - therapeutic use ; Azacitidine - adverse effects ; Azacitidine - therapeutic use ; Biological and medical sciences ; Bone marrow ; Cancer ; Cancer Research ; Care and treatment ; Chimerism ; Clinical trials ; Creatinine ; Critical Care Medicine ; Female ; Follow-Up Studies ; Graft versus host disease ; Hematologic and hematopoietic diseases ; Hematology ; Hematopoietic Stem Cell Transplantation ; Hematopoietic stem cells ; Humans ; Intensive ; Internal Medicine ; Leading ; leading-article ; Leukemia ; Leukemia, Myeloid, Acute - drug therapy ; Leukemia, Myeloid, Acute - mortality ; Leukemia, Myeloid, Acute - therapy ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Myelodysplastic syndromes ; Myelodysplastic Syndromes - drug therapy ; Myelodysplastic Syndromes - mortality ; Myelodysplastic Syndromes - therapy ; Neoplasm, Residual - therapy ; Oncology ; Recurrence ; Relapse ; Remission (Medicine) ; Stem cell transplantation ; Time Factors ; Transplantation ; Transplantation, Homologous ; Treatment Outcome ; Young Adult</subject><ispartof>Leukemia, 2012-03, Vol.26 (3), p.381-389</ispartof><rights>The Author(s) 2012</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2012 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Mar 2012</rights><rights>Copyright © 2012 Macmillan Publishers Limited 2012 Macmillan Publishers Limited</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c674t-d179839837f847e4f32d031aef317aa4c832c55e9946c7f3eab653af0a4745a03</citedby><cites>FETCH-LOGICAL-c674t-d179839837f847e4f32d031aef317aa4c832c55e9946c7f3eab653af0a4745a03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/leu.2011.234$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/leu.2011.234$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25702888$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21886171$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Platzbecker, U</creatorcontrib><creatorcontrib>Wermke, M</creatorcontrib><creatorcontrib>Radke, J</creatorcontrib><creatorcontrib>Oelschlaegel, U</creatorcontrib><creatorcontrib>Seltmann, F</creatorcontrib><creatorcontrib>Kiani, A</creatorcontrib><creatorcontrib>Klut, I-M</creatorcontrib><creatorcontrib>Knoth, H</creatorcontrib><creatorcontrib>Röllig, C</creatorcontrib><creatorcontrib>Schetelig, J</creatorcontrib><creatorcontrib>Mohr, B</creatorcontrib><creatorcontrib>Graehlert, X</creatorcontrib><creatorcontrib>Ehninger, G</creatorcontrib><creatorcontrib>Bornhäuser, M</creatorcontrib><creatorcontrib>Thiede, C</creatorcontrib><title>Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial</title><title>Leukemia</title><addtitle>Leukemia</addtitle><addtitle>Leukemia</addtitle><description>This study evaluated azacitidine as treatment of minimal residual disease (MRD) determined by a sensitive donor chimerism analysis of CD34
+
blood cells to pre-empt relapse in patients with CD34
+
myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT). At a median of 169 days after HSCT, 20/59 prospectively screened patients experienced a decrease of CD34
+
donor chimerism to <80% and received four azacitidine cycles (75 mg/m
2
/day for 7 days) while in complete hematologic remission. A total of 16 patients (80%) responded with either increasing CD34
+
donor chimerism to ⩾80% (
n
=10; 50%) or stabilization (
n
=6; 30%) in the absence of relapse. Stabilized patients and those with a later drop of CD34
+
donor chimerism to <80% after initial response were eligible for subsequent azacitidine cycles. A total of 11 patients (55%) received a median of 4 (range, 1–11) additional cycles. Eventually, hematologic relapse occurred in 13 patients (65%), but was delayed until a median of 231 days (range, 56–558) after initial decrease of CD34
+
donor chimerism to <80%. In conclusion, pre-emptive azacitidine treatment has an acceptable safety profile and can substantially prevent or delay hematologic relapse in patients with MDS or AML and MRD after allogeneic HSCT.</description><subject>Adult</subject><subject>Aged</subject><subject>Antimetabolites, Antineoplastic - adverse effects</subject><subject>Antimetabolites, Antineoplastic - therapeutic use</subject><subject>Azacitidine - adverse effects</subject><subject>Azacitidine - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bone marrow</subject><subject>Cancer</subject><subject>Cancer Research</subject><subject>Care and treatment</subject><subject>Chimerism</subject><subject>Clinical trials</subject><subject>Creatinine</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft versus host disease</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Leading</subject><subject>leading-article</subject><subject>Leukemia</subject><subject>Leukemia, Myeloid, Acute - drug therapy</subject><subject>Leukemia, Myeloid, Acute - mortality</subject><subject>Leukemia, Myeloid, Acute - therapy</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myelodysplastic syndromes</subject><subject>Myelodysplastic Syndromes - drug therapy</subject><subject>Myelodysplastic Syndromes - mortality</subject><subject>Myelodysplastic Syndromes - therapy</subject><subject>Neoplasm, Residual - therapy</subject><subject>Oncology</subject><subject>Recurrence</subject><subject>Relapse</subject><subject>Remission (Medicine)</subject><subject>Stem cell transplantation</subject><subject>Time Factors</subject><subject>Transplantation</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0887-6924</issn><issn>1476-5551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptksFvFCEUxidGY9fqzbMhGvXirjDAwHgwmazVmmxjYuvFC6HsY5eGgRVmNPrXy2bXtmuaIRnC93vfg5evqp4SPCOYyrcexlmNCZnVlN2rJoSJZso5J_erCZZSTJu2ZkfVo5yvMN6KzcPqqCZSNkSQSfWr-6ONG9zSBUA2JjQk0EMPYUDRItf35bzsE3i9yYBcQGcfzlHhurMF2ujBFTUjbQdISHsfVxDAGXR6Pr94V6ry6ItcnIY1oK8ni-57Vzo47R9XD6z2GZ7s_8fVt48nF_PT6eLLp8_zbjE1jWDDdElEK2lZwkomgFlaLzElGiwlQmtmJK0N59C2rDHCUtCXDafaYs0E4xrT4-r9znczXvawNOW6SXu1Sa7X6beK2qlDJbi1WsWfilLcECqLweu9QYo_RsiD6l024L0OEMes2kYSQVvRFvL5f-RVHFMor1NtXW7FCa8L9GIHrbQH5YKNpavZWqqulpRxLhgt1OwOqnxL6J2JAawr5wcFr24VrEH7YZ2jHwcXQz4E3-xAk2LOCez1KAhW2zypkie1zZMqeSr4s9vju4b_BagAL_eAzkZ7m3QwLt9wXOBayu0YpzsuFymsIN0M587GfwG2vN9r</recordid><startdate>20120301</startdate><enddate>20120301</enddate><creator>Platzbecker, U</creator><creator>Wermke, M</creator><creator>Radke, J</creator><creator>Oelschlaegel, U</creator><creator>Seltmann, F</creator><creator>Kiani, A</creator><creator>Klut, I-M</creator><creator>Knoth, H</creator><creator>Röllig, C</creator><creator>Schetelig, J</creator><creator>Mohr, B</creator><creator>Graehlert, X</creator><creator>Ehninger, G</creator><creator>Bornhäuser, M</creator><creator>Thiede, C</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20120301</creationdate><title>Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial</title><author>Platzbecker, U ; Wermke, M ; Radke, J ; Oelschlaegel, U ; Seltmann, F ; Kiani, A ; Klut, I-M ; Knoth, H ; Röllig, C ; Schetelig, J ; Mohr, B ; Graehlert, X ; Ehninger, G ; Bornhäuser, M ; Thiede, C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c674t-d179839837f847e4f32d031aef317aa4c832c55e9946c7f3eab653af0a4745a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antimetabolites, Antineoplastic - adverse effects</topic><topic>Antimetabolites, Antineoplastic - therapeutic use</topic><topic>Azacitidine - adverse effects</topic><topic>Azacitidine - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bone marrow</topic><topic>Cancer</topic><topic>Cancer Research</topic><topic>Care and treatment</topic><topic>Chimerism</topic><topic>Clinical trials</topic><topic>Creatinine</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft versus host disease</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Hematopoietic stem cells</topic><topic>Humans</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Leading</topic><topic>leading-article</topic><topic>Leukemia</topic><topic>Leukemia, Myeloid, Acute - drug therapy</topic><topic>Leukemia, Myeloid, Acute - mortality</topic><topic>Leukemia, Myeloid, Acute - therapy</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Myelodysplastic syndromes</topic><topic>Myelodysplastic Syndromes - drug therapy</topic><topic>Myelodysplastic Syndromes - mortality</topic><topic>Myelodysplastic Syndromes - therapy</topic><topic>Neoplasm, Residual - therapy</topic><topic>Oncology</topic><topic>Recurrence</topic><topic>Relapse</topic><topic>Remission (Medicine)</topic><topic>Stem cell transplantation</topic><topic>Time Factors</topic><topic>Transplantation</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Platzbecker, U</creatorcontrib><creatorcontrib>Wermke, M</creatorcontrib><creatorcontrib>Radke, J</creatorcontrib><creatorcontrib>Oelschlaegel, U</creatorcontrib><creatorcontrib>Seltmann, 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G</au><au>Bornhäuser, M</au><au>Thiede, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial</atitle><jtitle>Leukemia</jtitle><stitle>Leukemia</stitle><addtitle>Leukemia</addtitle><date>2012-03-01</date><risdate>2012</risdate><volume>26</volume><issue>3</issue><spage>381</spage><epage>389</epage><pages>381-389</pages><issn>0887-6924</issn><eissn>1476-5551</eissn><coden>LEUKED</coden><abstract>This study evaluated azacitidine as treatment of minimal residual disease (MRD) determined by a sensitive donor chimerism analysis of CD34
+
blood cells to pre-empt relapse in patients with CD34
+
myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT). At a median of 169 days after HSCT, 20/59 prospectively screened patients experienced a decrease of CD34
+
donor chimerism to <80% and received four azacitidine cycles (75 mg/m
2
/day for 7 days) while in complete hematologic remission. A total of 16 patients (80%) responded with either increasing CD34
+
donor chimerism to ⩾80% (
n
=10; 50%) or stabilization (
n
=6; 30%) in the absence of relapse. Stabilized patients and those with a later drop of CD34
+
donor chimerism to <80% after initial response were eligible for subsequent azacitidine cycles. A total of 11 patients (55%) received a median of 4 (range, 1–11) additional cycles. Eventually, hematologic relapse occurred in 13 patients (65%), but was delayed until a median of 231 days (range, 56–558) after initial decrease of CD34
+
donor chimerism to <80%. In conclusion, pre-emptive azacitidine treatment has an acceptable safety profile and can substantially prevent or delay hematologic relapse in patients with MDS or AML and MRD after allogeneic HSCT.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>21886171</pmid><doi>10.1038/leu.2011.234</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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ispartof | Leukemia, 2012-03, Vol.26 (3), p.381-389 |
issn | 0887-6924 1476-5551 |
language | eng |
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source | MEDLINE; Nature Journals Online; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SpringerLink Journals - AutoHoldings |
subjects | Adult Aged Antimetabolites, Antineoplastic - adverse effects Antimetabolites, Antineoplastic - therapeutic use Azacitidine - adverse effects Azacitidine - therapeutic use Biological and medical sciences Bone marrow Cancer Cancer Research Care and treatment Chimerism Clinical trials Creatinine Critical Care Medicine Female Follow-Up Studies Graft versus host disease Hematologic and hematopoietic diseases Hematology Hematopoietic Stem Cell Transplantation Hematopoietic stem cells Humans Intensive Internal Medicine Leading leading-article Leukemia Leukemia, Myeloid, Acute - drug therapy Leukemia, Myeloid, Acute - mortality Leukemia, Myeloid, Acute - therapy Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Male Medical sciences Medicine Medicine & Public Health Middle Aged Myelodysplastic syndromes Myelodysplastic Syndromes - drug therapy Myelodysplastic Syndromes - mortality Myelodysplastic Syndromes - therapy Neoplasm, Residual - therapy Oncology Recurrence Relapse Remission (Medicine) Stem cell transplantation Time Factors Transplantation Transplantation, Homologous Treatment Outcome Young Adult |
title | Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial |
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