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<p>Decitabine shows favorable efficacy in induction and maintenance therapy for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), but its role in pre-transplant conditioning still has not been established. We performed a systematic review and meta-analysis of comparative studies investigating the effects of adding decitabine to conditioning regimens in AML/MDS patients undergoing allogeneic hematopoietic stem cell transplantation. Meta-analysis was conducted with Review Manager 5.4. For time-to-event outcomes, pooled hazard ratios (HRs) were calculated using generic inverse-variance method. For dichotomous data, pooled risk ratios (RRs) were calculated using Mantel-Haenszel method. Fixed-effects model was adopted if there is no significant heterogeneity. Literature search and study selection identify 9 eligible studies, including 2 randomized controlled trials and 7 retrospective comparative studies. Meta-analysis show that addition of decitabine to conditioning regimen is associated with significantly better overall survival (HR 0.61; 95% CI: 0.49–0.76; <i>P</i> &lt; 0.00001), reduced risk of relapse (HR 0.58; 95% CI: 0.46–0.73; <i>P</i> &lt; 0.00001), and better disease-free survival (HR 0.67; 95% CI: 0.55–0.81; <i>P</i> &lt; 0.0001) without increasing non-relapse mortality (HR 0.82; 95% CI: 0.56–1.18; <i>P</i> = 0.28) and grade II-IV acute graft-versus-host disease (RR 0.75; 95% CI: 0.54–1.04; <i>P</i> = 0.08).</p>

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The effects of adding decitabine to conditioning regimen for patients with acute myeloid leukemia or myelodysplastic syndrome undergoing allogeneic hematopoietic stem cell transplantation: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月23日

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  • Chengxin Luo,
  • Jianmin Zhang,
  • Xiangtao Huang,
  • Guixian Wu,
  • Yarui Huang,
  • Yaqun Ding,
  • Zhen Huang,
  • Qiuyue Song,
  • Jieping Chen,
  • Xi Li,
  • Shuangnian Xu

摘要

Decitabine shows favorable efficacy in induction and maintenance therapy for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), but its role in pre-transplant conditioning still has not been established. We performed a systematic review and meta-analysis of comparative studies investigating the effects of adding decitabine to conditioning regimens in AML/MDS patients undergoing allogeneic hematopoietic stem cell transplantation. Meta-analysis was conducted with Review Manager 5.4. For time-to-event outcomes, pooled hazard ratios (HRs) were calculated using generic inverse-variance method. For dichotomous data, pooled risk ratios (RRs) were calculated using Mantel-Haenszel method. Fixed-effects model was adopted if there is no significant heterogeneity. Literature search and study selection identify 9 eligible studies, including 2 randomized controlled trials and 7 retrospective comparative studies. Meta-analysis show that addition of decitabine to conditioning regimen is associated with significantly better overall survival (HR 0.61; 95% CI: 0.49–0.76; P < 0.00001), reduced risk of relapse (HR 0.58; 95% CI: 0.46–0.73; P < 0.00001), and better disease-free survival (HR 0.67; 95% CI: 0.55–0.81; P < 0.0001) without increasing non-relapse mortality (HR 0.82; 95% CI: 0.56–1.18; P = 0.28) and grade II-IV acute graft-versus-host disease (RR 0.75; 95% CI: 0.54–1.04; P = 0.08).