Salvage therapy with decitabine in combination with granulocyte colony‐stimulating factor, low‐dose cytarabine, and aclarubicin in patients with refractory or relapsed early T‐cell precursor acute lymphoblastic leukemia

Meng, Tongyan; Yao, Yao; Xu, Yang; Xue, Shengli; Han, Yue; Tang, Xiaowen; Qiu, Huiying; Sun, Aining; Wu, Depei; Zhang, Yanming; Wang, Ying

doi:10.1002/hon.2783

Cited by 7 publications

(2 citation statements)

References 10 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, ETP-ALL has a higher rate of remission failure and subsequent relapse than typical T-ALL (37). Meng et al (38) reported that six patients with relapsed/refractory ETP-ALL were treated with decitabine combined with the CAG regimen (aclarubicin, cytarabine, and G-CSF), and five patients achieved CR. In this study, one patient with ETP-ALL initiated maintenance treatment with decitabine and has completed four cycles and is currently well at the date of last follow-up.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

View full text Add to dashboard Cite

BackgroundPost-transplant relapse remains a 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.MethodsIn this prospective study, we enrolled 34 patients with ALL who underwent allo-HSCT from August 2016 to April 2020 and received low-dose decitabine maintenance treatment after transplantation. The primary objectives were cumulative incidence of relapse rate (CIR), overall survival (OS), and disease-free survival (DFS). The secondary objectives were graft-versus-host disease (GVHD) and safety.ResultsAmong the enrolled 34 patients, 6 patients relapsed and 6 patients died. The 2-year CIR, OS, and DFS were 20.2, 77.5, and 73.6%, respectively. Subgroup analysis revealed the 2-year CIR, OS, and DFS rates of 12 patients with T-ALL/lymphoblastic lymphoma (LBL) were 8.3, 90, and 81.5%, respectively. None of the seven patients with T-ALL relapsed. During maintenance treatment, only one patient (2.9%) developed grade IV acute GVHD and four (11.8%) patients had severe chronic GVHD. Thirty-two patients (94.1%) developed only grade I to II myelosuppression, and two patients (5.8%) developed grade III to IV granulocytopenia.ConclusionsMaintenance treatment with low-dose decitabine after allo-HSCT may be used as a therapeutic option to reduce relapse in patients with adult ALL, especially in patients with T-ALL. Our findings require confirmation in larger-scale controlled trials.Clinical Trial RegistrationChinese Clinical Trials Registry, identifier ChiCTR1800014888.

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Another case series included six patients with relapse/refractory ETP-ALL treated with decitabine combined with G-CSF, low dose cytarabine, and aclarubicin. The treatment successfully brought the disease into control and allowed to bridge into allogenic HSC transplantation ( 105 ). Further pre-clinical and clinical studies to evaluate the combination of hypomethylating agents and venetoclax are needed.…”

Section: Novel Therapiesmentioning

confidence: 99%

Early T-Cell Precursor Acute Lymphoblastic Leukemia: Diagnosis, Updates in Molecular Pathogenesis, Management, and Novel Therapies

Sin

Man

2021

Front. Oncol.

View full text Add to dashboard Cite

Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a distinct subtype of T lymphoblastic leukemia (T-ALL) identified in 2009, due to its unique immunophenotypic and genomic profile. The outcome of patients was poor in earlier studies, and they were prone to have induction failure, with more frequent relapse/refractory disease. Recent advances had been made in discoveries of genetic aberrations and molecular pathogenesis of ETP-ALL. However, the diagnosis and management of ETP-ALL is still challenging. There are limited choices of novel therapies so far. In this review article, it highlighted the diagnostic issue of ETP-ALL, pitfall in diagnosis, and strategy of accurate diagnosis. The review also summarized current understanding of molecular mechanism of leukemogenesis. The emerging role of risk-adapted therapy and allogenic stem cell transplant in optimizing the outcome of patients with ETP-ALL was discussed. Finally, some potential novel therapies were proposed based on the current understanding of molecular pathogenesis.

show abstract

Impact of disease status at allogeneic stem cell transplantation on adolescent and young adult patients with early T‐cell precursor acute lymphoblastic leukemia

Meng

Zhu

et al. 2021

Hematological Oncology

Self Cite

View full text Add to dashboard Cite

Early T‐cell precursor (ETP) acute lymphoblastic leukemia (ALL) is an aggressive subset of T‐cell ALL, and the role of allogeneic hematopoietic stem cell transplantation (allo‐HSCT) in adolescent and young adult (AYA) patients has not been sufficiently described. We retrospectively analysed the data of 30 AYA patients (19 in first complete remission [CR1], 3 in CR2, and 8 with active disease) with ETP‐ALL who underwent myeloablative allogeneic hematopoietic stem cell transplantation (allo‐HSCT) from HLA‐matched related, n = 2, unrelated, n = 5, or HLA‐haploidentical related, n = 23 donors with an emphasis on the impact of disease status on the outcomes of transplant. The stem cell source was unmanipulated G‐CSF mobilized bone marrow or peripheral blood stem cells. All patients achieved neutrophil engraftment with full donor chimerism. The cumulative incidences of grade II to IV acute graft‐versus‐host disease (GVHD) and chronic GVHD at 2 years were 37% and 33%, respectively. Overall, 16 patients died. The causes of death were relapse (8 patients), infection (4 patients) and GVHD (4 patients). The estimated 2‐year overall survival (OS) and leukemia‐free survival (LFS) for the whole cohort were 47.8% and 46.2%, respectively. Patients transplanted in CR1/2 had significantly better 2‐year OS and LFS than patients with active disease (61.7% vs. 12.5%, p = 0.02; and 58.3% vs. 12.5%, p = 0.04, respectively). There was a trend toward an inferior OS rate in those patients in CR1 with chemoresistance or in CR2 compared with patients in CR1 with chemosensitivity, although this did not reach statistical significance. Our data support allo‐HSCT, especially from HLA‐haploidentical donors as an effective therapeutic strategy in AYA patients with ETP‐ALL and disease status was significantly associated with survival in these patients.

show abstract

Salvage therapy with decitabine in combination with granulocyte colony‐stimulating factor, low‐dose cytarabine, and aclarubicin in patients with refractory or relapsed early T‐cell precursor acute lymphoblastic leukemia

Cited by 7 publications

References 10 publications

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

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

Early T-Cell Precursor Acute Lymphoblastic Leukemia: Diagnosis, Updates in Molecular Pathogenesis, Management, and Novel Therapies

Impact of disease status at allogeneic stem cell transplantation on adolescent and young adult patients with early T‐cell precursor acute lymphoblastic leukemia

Contact Info

Product

Resources

About