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| Efficacy of Maintenance Therapy with Decitabine-Containing Chemotherapy in Patients with Relapsed AML after Allogeneic Hematopoietic Stem Cell Transplantation |
| WU Yan, LIU Yan, et al |
| West China Hospital,Sichuan University, Sichuan Chengdu 610041, China |
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Abstract Objective: To explore the therapeutic effects of decitabine combined with FLAG chemotherapy regimen on patients with recurrent acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: The clinical data of 95 patients with recurrent AML after allo-HSCT treatment between January 2014 and June 2020 were retrospectively analyzed. According to different treatment regimens, 95 patients were divided into combined group (51 cases) and FLAG group (44 cases). Combined group was given decitabine (5~7mg/m2/d, subcutaneous injection, d1~d5) combined with FLAG regimen, and FLAG group was treated with FLAG regimen, and the two groups had the same symptomatic and supportive treatment. The efficacy was reviewed after 4 weeks of treatment, and the toxic and side effects of chemotherapy and status of symptomatic and supportive treatment were recorded in the two groups. June 31, 2022 was the deadline for follow-up, and Kaplan-meier survival analysis was used to record the overall survival time and 2-year survival rate in the two groups. Results: After treatment, the complete remission rate (CR) and overall response rate (ORR) with 50.98% and 80.39% in combined group were higher than those in FLAG group with 34.09% and 56.82%. There was a statistically significant difference in the ORR (P<0.05). During chemotherapy, there were no statistically differences between the two groups in terms of adverse reactions such as bone marrow suppression (Z=0.18, P=0.855), gastrointestinal reactions (Z=0.63, P=0.531), liver injury (Z=1.06, P=0.288), bleeding (Z=0.61, P=0.540), and pulmonary infection (Z=0.33, P=0.739) (P>0.05). There was no statistically significant difference in the comparison of the rates of deleterious erythrocyte suspension, platelets, and antibiotic application between the 2 groups (P>0.05). As of June 31, 2022, the median overall survival time and 2-year overall survival rate with 14.5 (1.2-34.8) months and 41.18% in combined group were higher than those in FLAG group with 11.4 (0.9~26.9) months and 22.73%. However, Log-rank test showed that there was no significant difference in survival rate between the two groups (Log-rank χ2=3.758, P=0.053). Conclusion: On the basis of FLAG regimen, combined with decitabine in the treatment of patients with recurrent AML after allo-HSCT can achieve better short-term efficacy without increasing the adverse reactions of chemotherapy.
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2023, Vol. 29 
