摘要
Objective To assess the efficacy and toxicity of decitabine-based conditioning regimen in patients with myelodysplastic syndrome(MDS),acute myeloid leukemia secondary to MDS(MDS-AML)or chronic myelomonocytic leukemia(CMML).Methods From March 1,2013 to May 25,2015,22 patients who underwent allogenic hematopoietic stem cell transplantation(allo-HSCT)with decitabine-based conditioning regimen were analyzed retrospectively.Results①22 patients,14 males and 8 females with a median age of 42.5(24-56)years old,were diagnosed as MDS(n=14),CMML(n=4),MDS-AML(n=4).②15 patients were treated with the conditioning regimen of decitabine combined with busulfan,cyclophosphamide,fludarabine,and cytarabine,the other 7 cases were treated with decitabine,busulfan,fludarabine,and cytarabine.The dose of decitabine was 20 mg·m^-2·d^-1 for 5 days.Rabbit anti-human anti-thymocyte globulin(2.5 mg·kg^-1·d^-1 for 4 days)was involved in conditioning regimen in patients with unrelated donor or haploidentical transplantation.③Except 1 patient died of infection in 2 months after transplantation,the other patients were engrafted successfully.The median time of granulocyte engraftment was 13(12-18)days,and the median time of platelet engraftment was 16(13-81)days.④The incidence of acute graft versus host disease(aGVHD)was(41.3±10.6)%,and severe aGVHD(grade ofⅢ-Ⅳ)was(18.4±9.7)%.The incidence of chronic graft versus host disease(cGVHD)was(56.4±11.3)%,and extensive cGVHD was(36.4±12.1)%.⑤8 patients were suffered with cytomegalovirus(CMV)viremia.Among the 18 patients with definite infection,6 occurred during myelosuppression and 12 cases occurred after hematopoietic reconstruction.The 2-year and 3-year nonrelapse mortality was(13.9±7.4)%and(24.3±9.5)%,respectively.⑥The 2-year and 3-year overallsurvival(OS)was(77.3±8.9)%and(67.9±10.0)%,respectively.The 2-year and 3-year relapsefreesurvival(RFS)was(72.7±9.5)%and(63.6±10.3)%,respectively.Conclusion allo-HSCT withdecitabine-based conditioning regimen is feasible in thetreatment of MDS,MDS-AML or CMML.
