Therapeutic efficacies of decitabine application prior to hematopoietic cell transplantation in patients with myelodysplastic syndrome and acute myeloid leukemia

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. Key words: Myelodysplastic syndrome; Leukemia, myeloid, acute; Hematopoietic cell transplantation; Decitabine