A 7-day decitabine included conditioning regimen accelerated donor hematopoietic engraftment while reduced the occurrence of mucositis without interfering with prognosis

Introduction: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the standard and curative treatment strategy for patients with hematologic malignancies. Recently, decitabine included regimens are investigated by several studies including ours, which may prevent relapse of primary malignant diseases. Methods: This study was to retrospectively evaluate a 7-day decitabine included regimen with reduced dose of idarubicin for patients with hematologic malignancies who underwent allo-HSCT. Results: A total of 84 patients were enrolled, including 24 cases in 7-day and 60 cases in 5-day decitabine groups, respectively. Patients conditioned with 7-day decitabine regimen showed accelerated neutrophil (12.05±1.97 versus 13.86±3.15; u = 9.309, P <0.001) and platelet (16.32±6.27 versus 21.37±8.57; u = 8.887, P <0.001) engraftment compared with those treated with 5-day decitabine regimen. Patients in the 7-day decitabine group showed a significantly lower incidence rate of total (50.00% (12/24) versus 78.33% (47/60); 2 = 6.583, P = 0.010) and grade III or above (4.17% (1/24) versus 31.67% (19/60); 2 = 7.147, P = 0.008) oral mucositis compared to those in 5-day decitabine group. However, the occurrence of other major complications post allo-HSCT and outcome of patients in these two groups were comparable. Conclusion: These results demonstrated that this 7-day decitabine contained new conditioning regimen seems to be feasible and safe for patients with myeloid neoplasms who receive allo-HSCT, and a large-scale prospective study is needed to confirm the findings of this study.