Objective: To explore the therapeutic efficacies of decitabine application prior to hematopoietic cell transplantation (HSCY) in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML).
Methods: Retrospective reviews were conducted for 46 patients with MDS (n = 14) and AML (n = 32) on a therapy of decitabine prior to allo-HSCT between September 2009 and February 2013.
Results: In MDS patients, complete remission (CR, n = 10), partial remission (PR, n = 2) and stable disease (SD, n = 1) were achieved prior to HSCT. And the remission rate of one course was 10/14. After decitabine dosing, 17/32 patients achieved CR in 32 with AML and the remission rate of one course was 53.1％ (17/32) and effective rate of one course (CR+PR) achieves 78.1％ (25/32). Successful engraftment was attained in all MDS patients and 12/14 patients survived disease-free and one died of pneumonia after relapse. And 28 patients with AML attained successful engraftment after using decitabine prior to allo-HSCT and there were 20 disease-free survivors. Ten patients died and another lived with tumor. The incidences of acute and chronic graft-versus-host disease (GVHD) among evaluable patients were 4.3% (2/26) and 23.9% (11/46) respectively. After a median follow-up of 8 months for survivors, the treatment-related mortality was 23.9% (11/46). The 30-month disease-free survival (DFS) rate was 53.1% and 30-month overall survival rate after decitabine dosing 61.9%.
Conclusion: Thus decitabine is an effective therapy during bridge time to HSCT in patients with MDS and AML.