Impact of azacitidine before allogeneic stem-cell transplantation for myelodysplastic syndromes: a study by the Société Française de Greffe de Moelle et de Thérapie-Cellulaire and the Groupe-Francophone des Myélodysplasies.

Gandhi Damaj 1 Alain Duhamel 2 Marie Robin 3 Yves Beguin 4 Mauricette Michallet 5 Mohamad Mohty 6 Stephane Vigouroux 7 Pierre Bories 8 Alice Garnier 9 Jean El Cheikh 10 Claude-Eric Bulabois 11 Anne Huynh 12 Jacques-Olivier Bay 13 Faeyzeh Legrand 14 Eric Deconinck 15 Nathalie Fegueux 16 Laurence Clement 17 Charles Dauriac 18 Natacha Maillard 19 Jérôme Cornillon 20 Lionel Ades 21 Gaelle Guillerm 22 Aline Schmidt-Tanguy 23 Zora Marjanovic 24 Sophie Park 25 Marie-Thérèse Rubio 24 Jean-Pierre Marolleau 1 Federico Garnier 26 Pierre Fenaux 27 Ibrahim Yakoub-Agha 28, *
Abstract : PURPOSE: To investigate the impact of prior-to-transplantation azacitidine (AZA) on patient outcome after allogeneic stem-cell transplantation (alloSCT) for myelodysplastic syndrome (MDS). PATIENTS AND METHODS: Of the 265 consecutive patients who underwent alloSCT for MDS between October 2005 and December 2009, 163 had received cytoreductive treatment prior to transplantation, including induction chemotherapy (ICT) alone (ICT group; n = 98), AZA alone (AZA group; n = 48), or AZA preceded or followed by ICT (AZA-ICT group; n = 17). At diagnosis, 126 patients (77%) had an excess of marrow blasts, and 95 patients (58%) had intermediate-2 or high-risk MDS according to the International Prognostic Scoring System (IPSS). Progression to more advanced disease before alloSCT was recorded in 67 patients. Donors were sibling (n = 75) or HLA-matched unrelated (10/10; n = 88). They received blood (n = 142) or marrow (n = 21) grafts following either myeloablative (n = 33) or reduced intensity (n = 130) conditioning. RESULTS: With a median follow-up of 38.7 months, 3-year outcomes in the AZA, ICT, and AZA-ICT groups were 55%, 48%, and 32% (P = .07) for overall survival (OS); 42%, 44%, and 29% (P = .14) for event-free survival (EFS); 40%, 37%, and 36% (P = .86) for relapse; and 19%, 20%, and 35% (P = .24) for nonrelapse mortality (NRM), respectively. Multivariate analysis confirmed the absence of statistical differences between the AZA and the ICT groups in terms of OS, EFS, relapse, and NRM. CONCLUSION: With the goal of downstaging underlying disease before alloSCT, AZA alone led to outcomes similar to those for standard ICT.
Type de document :
Article dans une revue
Journal of Clinical Oncology, American Society of Clinical Oncology, 2012, 30 (36), pp.4533-40. 〈10.1200/JCO.2012.44.3499〉
Liste complète des métadonnées

http://www.hal.inserm.fr/inserm-00821506
Contributeur : Philippe Saas <>
Soumis le : vendredi 10 mai 2013 - 14:50:11
Dernière modification le : jeudi 20 septembre 2018 - 17:02:01

Identifiants

Citation

Gandhi Damaj, Alain Duhamel, Marie Robin, Yves Beguin, Mauricette Michallet, et al.. Impact of azacitidine before allogeneic stem-cell transplantation for myelodysplastic syndromes: a study by the Société Française de Greffe de Moelle et de Thérapie-Cellulaire and the Groupe-Francophone des Myélodysplasies.. Journal of Clinical Oncology, American Society of Clinical Oncology, 2012, 30 (36), pp.4533-40. 〈10.1200/JCO.2012.44.3499〉. 〈inserm-00821506〉

Partager

Métriques

Consultations de la notice

1036