Guadecitabine improved relapse-free survival in high-risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant: phase II results from a single center

This phase 2, single-center clinical trial evaluated the efficacy and safety of guadecitabine, with or without donor lymphocyte infusion, following allogeneic stem cell transplantation (allo-SCT) in adult patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). The study had t...

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Main Authors: Betül Oran, Peter Thall, Amin Alousi, Gheath Al-Atrash, Rohtesh Mehta, David Marin, Partow Kebriaei, Uday Popat, Roland Bassett, Qaiser Bashir, Jin Im, Amanda Olson, Jessica Jewell, Portia Smallbone, Elizabeth Shpall, Richard Champlin
Format: Article
Language:English
Published: Ferrata Storti Foundation 2025-07-01
Series:Haematologica
Online Access:https://haematologica.org/article/view/12186
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author Betül Oran
Peter Thall
Amin Alousi
Gheath Al-Atrash
Rohtesh Mehta
David Marin
Partow Kebriaei
Uday Popat
Roland Bassett
Qaiser Bashir
Jin Im
Amanda Olson
Jessica Jewell
Portia Smallbone
Elizabeth Shpall
Richard Champlin
author_facet Betül Oran
Peter Thall
Amin Alousi
Gheath Al-Atrash
Rohtesh Mehta
David Marin
Partow Kebriaei
Uday Popat
Roland Bassett
Qaiser Bashir
Jin Im
Amanda Olson
Jessica Jewell
Portia Smallbone
Elizabeth Shpall
Richard Champlin
author_sort Betül Oran
collection DOAJ
description This phase 2, single-center clinical trial evaluated the efficacy and safety of guadecitabine, with or without donor lymphocyte infusion, following allogeneic stem cell transplantation (allo-SCT) in adult patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). The study had three treatment cohorts based on disease status post-transplant. Cohort 1 included patients with hematological relapse after transplant (n=13). Cohort 2 consisted of patients with minimal residual disease (MRD) detected after transplant (n=18). Cohort 3 compromised of patients in remission without MRD within 100 days post-transplant (n=24). The primary objectives were to achieve morphological complete remission (CR) in cohort 1 and MRD eradication in cohort 2 within six cycles of guadecitabine. Cohort 3 patients received 12 cycles to improve relapse-free survival (RFS). In cohort 1, 21.4% of patients achieved morphological CR. In cohort 2, 47.1% achieved MRD eradication. Those who cleared MRD had a 2-year RFS of 62.5%. Cohort 3 patients had a 2-year RFS rate was 62.5% with a median follow-up of 48 months. No unexpected adverse events (AEs) occurred, and no graft failures were observed. Guadecitabine demonstrated efficacy and a favorable safety profile across all cohorts, supporting the investigations of hypomethylating agents.
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institution Kabale University
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spelling doaj-art-bd8a456b59af415f8299581eb18ed8b92025-08-20T03:31:46ZengFerrata Storti FoundationHaematologica0390-60781592-87212025-07-01999110.3324/haematol.2025.287628Guadecitabine improved relapse-free survival in high-risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant: phase II results from a single centerBetül Oran0Peter Thall1Amin Alousi2Gheath Al-Atrash3Rohtesh Mehta4David Marin5Partow Kebriaei6Uday Popat7Roland Bassett8Qaiser Bashir9Jin Im10Amanda Olson11Jessica Jewell12Portia Smallbone13Elizabeth Shpall14Richard Champlin15Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Biostatistics, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Biostatistics, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer CenterDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center This phase 2, single-center clinical trial evaluated the efficacy and safety of guadecitabine, with or without donor lymphocyte infusion, following allogeneic stem cell transplantation (allo-SCT) in adult patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). The study had three treatment cohorts based on disease status post-transplant. Cohort 1 included patients with hematological relapse after transplant (n=13). Cohort 2 consisted of patients with minimal residual disease (MRD) detected after transplant (n=18). Cohort 3 compromised of patients in remission without MRD within 100 days post-transplant (n=24). The primary objectives were to achieve morphological complete remission (CR) in cohort 1 and MRD eradication in cohort 2 within six cycles of guadecitabine. Cohort 3 patients received 12 cycles to improve relapse-free survival (RFS). In cohort 1, 21.4% of patients achieved morphological CR. In cohort 2, 47.1% achieved MRD eradication. Those who cleared MRD had a 2-year RFS of 62.5%. Cohort 3 patients had a 2-year RFS rate was 62.5% with a median follow-up of 48 months. No unexpected adverse events (AEs) occurred, and no graft failures were observed. Guadecitabine demonstrated efficacy and a favorable safety profile across all cohorts, supporting the investigations of hypomethylating agents. https://haematologica.org/article/view/12186
spellingShingle Betül Oran
Peter Thall
Amin Alousi
Gheath Al-Atrash
Rohtesh Mehta
David Marin
Partow Kebriaei
Uday Popat
Roland Bassett
Qaiser Bashir
Jin Im
Amanda Olson
Jessica Jewell
Portia Smallbone
Elizabeth Shpall
Richard Champlin
Guadecitabine improved relapse-free survival in high-risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant: phase II results from a single center
Haematologica
title Guadecitabine improved relapse-free survival in high-risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant: phase II results from a single center
title_full Guadecitabine improved relapse-free survival in high-risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant: phase II results from a single center
title_fullStr Guadecitabine improved relapse-free survival in high-risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant: phase II results from a single center
title_full_unstemmed Guadecitabine improved relapse-free survival in high-risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant: phase II results from a single center
title_short Guadecitabine improved relapse-free survival in high-risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant: phase II results from a single center
title_sort guadecitabine improved relapse free survival in high risk acute myeloid leukemia and myelodysplastic syndrome patients after transplant phase ii results from a single center
url https://haematologica.org/article/view/12186
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