"Azacitidine maintenance therapy postallogeneic stem cell transplantati" by Amany R. Keruakous, Jennifer Holter-Chakrabarty et al.

Article Title

Azacitidine maintenance therapy postallogeneic stem cell transplantation in poorrisk acute myeloid leukemia

Authors

Amany R. Keruakous, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK 73104, USA
Jennifer Holter-Chakrabarty, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK 73104, USA
Sarah A. Schmidt, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK 73104, USA
Mohamad O. Khawandanah, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK 73104, USA
George Selby, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK 73104, USA
Carrie Yuen, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK 73104, USAFollow

Abstract

Objective/Background: Allogeneic hematopoietic stem cell transplant (HSCT) is the potential curative modality for poor-risk acute myeloid leukemia (AML), relapse remains the main reason for transplant failure. Early-phase studies showed azacitidine is safe for post-transplant maintenance therapy in AML. Methods: We performed a single institutional prospective cohort study to evaluate the benefit of azacitidine maintenance therapy following allogeneic HSCT in poor-risk AML. The main objective of this study is to generate a hypothesis aiming to optimize post-transplantation outcomes in poor-risk AML. Forty-nine adults with poor-risk AML who underwent allogeneic HSCT were evaluated in a nonrandomized prospective cohort fashion. Thirty-one participants received post-transplant azacitidine (32 mg/m2) on Days 1–5 for a 28-day treatment cycle beginning approximately 40 days after transplantation. The study was controlled using 18 matched individuals who were on a noninterventional surveillance protocol. Results: The relapse rate was significantly higher in the control cohort (66.67%) versus (25.81%) in the azacitidine maintenance cohort (p < .005). Time to relapse was significantly prolonged by azacitidine maintenance, not reached versus 4.1 months in the control arm (p < .0001). In addition, median overall survival was lower in the control cohort at 7.6 versus 27.4 months in the interventional cohort (p < .0001). At a median follow-up of 24 months, incidence of graftversus- host disease (GVHD) did not differ between study groups (p = .325). In both cohorts, minimal residual disease was correlated with higher hazard of relapse (95% confidence interval, 2.31–13.74; p < .001).

Recommended Citation

Keruakous, Amany R.; Holter-Chakrabarty, Jennifer; Schmidt, Sarah A.; Khawandanah, Mohamad O.; Selby, George; and Yuen, Carrie (2023) "Azacitidine maintenance therapy postallogeneic stem cell transplantation in poorrisk acute myeloid leukemia," Hematology/Oncology and Stem Cell Therapy: Vol. 16 : Iss. 1 , Article 5.
Available at: https://doi.org/10.1016/j.hemonc.2021.03.001