Email this article Low doses of decitabine for prevention of relapse after allogeneic hematopoietic stem cell transplantation: a single-center experience
- Authors: Ilushina M.A.1, Shelikhova L.N.1, Shasheleva D.A.1, Khismatullina R.D.1, Shipitsina I.P.1, Gutovskaya E.I.1, Kalinina I.I.1, Maschan A.A.1, Maschan M.A.1
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Affiliations:
- Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology
- Issue: Vol 17, No 2 (2018)
- Pages: 59-68
- Section: ORIGINAL ARTICLES
- Submitted: 20.09.2018
- Published:
- URL: https://hemoncim.com/jour/article/view/176
- DOI: https://doi.org/10.24287/1726-1708-2018-17-2-59-68
- ID: 176
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Abstract
Relapse, graft-versus-host disease (GvHD) and GvHD-associated mortality are major obstacles to success of transplantation from allogenic donors in children with hematologic malignancies. Negative depletion of αβ (+) T-cells and CD19+ B lymphocytes, which permits to maintain mature donor-derived natural killer cells and γδ(+) T cells in the graft may improve GvHD control, but decrease GVL (graft versus leukemia) effect. Additional attempts at relapse prevention may be posttransplant use of hypomethylating agents. In this article, we report the results of a pilot study of decitabine safety in children with hematologic malignancies after allogeneic HSCT in our center. A total of 63 pediatric patients with hematologic malignancies underwent allogeneic HSCT between May 2012 and November 2013 enrolled in this study. Group «Decitabine+» consisted of 33 patients (14 – AML, 12 – ALL, 6 – UMML), group «Decitabine-» 31 patients (12 – AML, 17 – ALL, 2 – UMML). Decitabine was used in low dose 10 mg/m2/day during 5 days. 32 patients recieved 133 courses with median number of courses 4 (2–6). Hematologic toxicity included grade IV neutropenia in 35%, grade III in 33%, grade II in 19%; grade IV thrombocytopenia in 7,6%, grade III in 7%, infections complicated in 33%. In group «Decitabine+» 11 of the 32 patients experienced disease relapse, (mean of time to relapse 1 year), in group «Decitabine-» 9 patients (mean of time 0,42 y), p = 0,13. Decitabine can be administered to children on outpatient basis post-transplant with mostly moderate hematologic and mild visceral toxicity. Efficacy of post-transplant decitabine can be safely evaluated in a prospective controlled trial.
About the authors
M. A. Ilushina
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology
Author for correspondence.
Email: maria.ilushina@gmail.com
MD, MDhematologist
Russia 117997, Moscow, Samory Mashela st., 1
Russian FederationL. N. Shelikhova
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology
ORCID iD: 0000-0003-0520-5630
Russian Federation
D. A. Shasheleva
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, ImmunologyRussian Federation
R. D. Khismatullina
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, ImmunologyRussian Federation
I. P. Shipitsina
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology
ORCID iD: 0000-0001-8687-5497
Russian Federation
E. I. Gutovskaya
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology
ORCID iD: 0000-0002-3800-8927
Russian Federation
I. I. Kalinina
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology
ORCID iD: 0000-0002-0813-5626
Russian Federation
A. A. Maschan
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology
ORCID iD: 0000-0002-0016-6698
Russian Federation
M. A. Maschan
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology
ORCID iD: 0000-0003-1735-0093
Russian Federation
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