AUTHOR=Liu Jia , Jiang Zhong-Xing , Xie Xin-Sheng , Wan Ding-Ming , Cao Wei-Jie , Wang Meng , Liu Zhen-Zhen , Dong Zhen-Kun , Wang Hai-Qiong , Lu Run-Qing , Zhang Yin-Yin , Cheng Qian-Qian , Fan Ji-Xin , Li Wei , He Fei , Guo Rong 

TITLE=Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.710545

DOI=10.3389/fonc.2021.710545

ISSN=2234-943X

ABSTRACT=Background: Post-transplant relapse remains to be one principal leading cause of failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with adult acute lymphoblastic leukemia (ALL). The aim of this study was to investigate the efficacy and safety of low-dose decitabine on the prevention of adult ALL relapse after allo-HSCT.
Methods: In this prospective study, we enrolled 34 patients with ALL who underwent allo-HSCT from August 2016 to April 2020 and gave them low-dose decitabine maintenance treatment after transplantation. Relapse, graft-versus-host disease (GVHD) and overall survival (OS) were observed, and the safety of the regimen was evaluated.
Results: Among the enrolled 34 patients, 32 patients (94.1%) developed only grade I-II myelosuppression, 6 patients relapsed and 6 patients died. The 2-year cumulative incidence of relapse rate (CIR), OS and disease-free survival (DFS) were 20.2%, 77.5% and 73.6%, respectively. The 2-year CIR, OS and DFS of 12 patients with T-ALL/Lymphoblastic Lymphoma (LBL) were 8.3%, 90% and 81.5%, respectively. Among the 7 patients with T-ALL, no one relapsed. During maintenance treatment, only 1 patient (2.9%) developed grade IV acute GVHD and 4 (11.8%) patients had severe chronic GVHD.
Conclusions: Maintenance treatment with low-dose decitabine after allo-HSCT was associated with good tolerance, a low relapse rate without significantly affecting GVHD, and satisfactory survival in patients with ALL, especially patients with T-ALL.
Clinical Trial Registration: Chinese Clinical Trials Registry, identifier ChiCTR1800014888.