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Academic Journal
Azacitidine and lenalidomide combination: a novel relapse prophylaxis regimen after allogeneic hematopoietic stem-cell transplantation in patients with acute myeloid leukemia
Yimei Feng, Ting Chen, Yun Zhang, Han Yao, Ping Wang, Lu Wang, Kaniel Cassady, Zhongmin Zou, Yuqing Liu, Lu Zhao, Lei Gao, Xi Zhang, Peiyan Kong
Frontiers in Immunology, Vol 14 (2023)
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| Title | Azacitidine and lenalidomide combination: a novel relapse prophylaxis regimen after allogeneic hematopoietic stem-cell transplantation in patients with acute myeloid leukemia |
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| Authors | Yimei Feng, Ting Chen, Yun Zhang, Han Yao, Ping Wang, Lu Wang, Kaniel Cassady, Zhongmin Zou, Yuqing Liu, Lu Zhao, Lei Gao, Xi Zhang, Peiyan Kong |
| Publication Year |
2023
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| Source |
Frontiers in Immunology, Vol 14 (2023)
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| Description |
IntroductionWhile allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be a curative regimen for acute myeloid leukemia (AML), relapse of AML remains a serious risk post-transplantation. Once relapsed, salvage options are limited and management of AML is difficult. Here we designed a prospective study to examine the efficacy and tolerability of maintenance therapy with azacytidine (AZA) plus low-dose lenalidomide (LEN) to prevent relapse after allo-HSCT for AML patients (ChiCTR2200061803).MethodsAML patients post-allo-HSCT were treated with AZA (75 mg/m2 for 7 days), followed by LEN (5 mg/m2, day 10-28), and a 4-week resting interval, which was defined as one treatment cycle. A total of 8 cycles was recommended. Results37 patients were enrolled, 25 patients received at least 5 cycles, and 16 patients finished all 8 cycles. With a median follow-up time of 608 (43-1440) days, the estimated 1-year disease free survival (DFS) was 82%, cumulative incidence of relapse (CIR) was 18%, and overall survival (OS) was 100%. Three patients (8%) had grade 1-2 neutropenia without fever; one patient developed grade 3-4 thrombocytopenia and minor subdural hematoma; 4/37 patients (11%) developed chronic GVHD with a score of 1-2, without requiring systemic treatment; No patient developed acute GVHD. After AZA/LEN prophylaxis, increasing numbers of CD56+NK and CD8+ T, and decreasing of CD19+ B cells were observed. DiscussionAzacitidine combined with low-dose lenalidomide was observed to be an effective relapse prophylaxis option after allo-HSCT in AML patients, and can be administered safely without significantly increasing the risk of GVHD, infection and other AEs.Clinical Trial Registrationwww.chictr.org, identifier ChiCTR2200061803.
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| Document Type |
article
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| Language |
English
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| Publisher Information |
Frontiers Media S.A., 2023.
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| Subject Terms | |
