Azacitidine Before Allogeneic Hematopoietic Cell Transplantation (AHCT) for Myelodysplasias
Slides from the journal article and transcribed comments from a recent interview with Steven D Gore, MD (10/8/09) below
Presentation discussed in this issue:
Field T et al. 5-Azacitidine for myelodysplasia before allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2009;[Epub ahead of print]. Abstract
STEVEN D GORE, MD: Allogeneic stem cell transplant is the only curative therapy for myelodysplastic syndrome (MDS). However, in patients with high-risk MDS, who tend to be the individuals receiving transplants currently, the probability of disease-free outcome at three years is about 30 percent. Many clinicians therefore are interested in knowing whether the use of a DNA methyltransferase inhibitor, such as azacitidine or decitabine, prior to transplant, is a reasonable approach.
This retrospective study compared the post-transplant outcomes of patients who did or did not receive 5-azacitidine therapy prior to transplant. It demonstrated that there was no statistical difference in the outcome between the two groups, although there was a trend toward decreased early relapse in the patients who received 5-azacitidine. I believe this study shows that the approach of administering 5-azacitidine before transplantation is feasible, but a prospective study would need to be performed to confirm it.
Dr Gore is Professor of Oncology at Johns Hopkins University in Baltimore, Maryland.