Clinical observation of feasibility and efficacy of decitabine bridge therapy followed by allogeneic hematopoietic stem cell transplantation in patients with myelodysplastic syndrome and acute myeloid leukemia

Objective: To investigate the feasibility and efficacy of DAC (decitabine) bridge therapy followed by allo-HSCT (allogeneic hematopoietic stem cell transplantation) in patients with MDS (myelodysplastic syndrome) and AML (acute myeloid leukemia). Methods: Seven patients with MDS and 12 patients with AML received DAC bridge therapy followed by allo-HSCT. Results: With DAC bridge therapy, 4 MDS patients achieved complete remission/marrow complete remission and 3 remained stable disease before allo-HSCT. After successful engraftment attained in all the seven MDS patients, six survived without disease, one received donor lymphocyte infusion and obtained complete remission after relapse and eventually died of pneumonia. Of 12 AML patients, 6 achieved complete remission after DAC bridge therapy; 5 survived without disease, one still survived but having disease, and 6 had died. The rates of acute and chronic GVHD were 31.6% and 21.1%, respectively. The two-year overall survival rate and the two-year cumulative recurrence rate were 57.9% and 36.2% after allo-HSCT, respectively. The two-year cumulative recurrence-free rate was 23.6% after allo-HSCT. Conclusion: DAC regimen can be safely and efficiently administrated to bridge time to allo-HSCT in patients with MDS/AML. DOI:10.3781/j.issn.1000-7431.2013.03.010