Evaluating the effectiveness of decitabine combined with allogeneic hematopoietic stem cell transplantation for the treatment of patients with recurrent and refractory acute myeloid leukemia.

This study evaluated the effectiveness of decitabine (Dacogen) combined with allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of patients with recurrent and refractory (r/r) acute myeloid leukemia (AML). The data showed that decitabine combined with allo-HSCT reduced the risk of recurrence and improved disease-free survival in these patients.

AML is a cancer of the blood and bone marrow leading to abnormal white blood cells. AML most commonly affects adults and elderly patients. It is often treated with powerful chemotherapy. Although chemotherapy results in remission in many older patients, relapse is common and overall survival is poor. These patients are normally treated with allo-HSCT and salvage treatments.

Allo-HSCT involves taking stem cells from one person and transplanting them into the AML patient to allow the development of new blood cells. However, many patients experience relapse (worsening of the disease) or refractory (not responsive to the treatment) after allo-HSCT. Patients with r/r AML usually benefit from salvage therapies.

Decitabine is a chemotherapy that alters the DNA of cancer cells and prevents their spreading. Decitabine has been shown to significantly improve the outcomes of patients with AML. However, there are few studies evaluating the effectiveness of decitabine combined with allo-HSCT for the treatment of patients with r/r AML.

This study analyzed 8 other studies and involved 795 patients with r/r AML. 294 patients received decitabine combined with allo-HSCT. 501 patients received allo-HSCT alone.

Decitabine combined with allo-HSCT significantly reduced the risk of recurrence by 71% compared to allo-HSCT alone.

Patients who received decitabine combined with allo-HSCT were 2.17 times more likely to survive without any signs or symptoms of cancer (disease-free) compared to patients who received allo-HSCT alone.

Decitabine combined with allo-HSCT significantly reduced the risk of graft-related death by 50% compared to allo-HSCT alone.

The study concluded that decitabine combined with allo-HSCT reduced the risk of recurrence and improved disease-free survival in patients with r/r AML.

This study looked back in time at medical records. The sample size was very small. Larger studies are needed.