Hypomethylating agent maintenance after allo-HSCT for acute leukemia

Li L, Zhang R, Cao W, et al. Comparative Analysis of Hypomethylating Agents as Maintenance Therapy after Allogeneic Hematopoietic Stem Cell Transplantation for High-Risk Acute Leukemia. Leukemia & Lymphoma. 2023; (doi: 10.1080/10428194.2023.2252948).

Maintenance therapy with hypomethylating agents may lower the risk of relapse post-allogeneic hematopoietic stem cell transplantation (allo-HSCT) and increase survival in patients with high-risk acute leukemia, according to new research. The retrospective study included 136 patients: 76 who received hypomethylating agents (decitabine, N=40; azacitidine, N=36) as maintenance therapy after undergoing allo-HSCT, and 60 who did not receive maintenance therapy. At 3 years, the incidence of relapse in the hypomethylating group was 16.6% compared with 39.2% in the control group. The 3-year rate of overall survival (OS) was 84.0% in the maintenance group and 60.0% in the control group, while disease-free survival at 3 years was 78.6% and 58.0%, respectively. Within the maintenance group, the 3-year relapse rate for patients who received decitabine was 8.5% compared with 25.0% for patients who received azacitidine. The risk of grade 3-4 neutropenia was higher in the decitabine group than the azacitidine group, at 20.0% vs. 2.8%.

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Tags: AlloHCT, Allo-HCT, OS, survival rate, hematopoietic transplantation, Allo-HSCT, post-HSCT