000141767 001__ 141767 000141767 005__ 20240229105130.0 000141767 0247_ $$2doi$$a10.1016/S1470-2045(18)30580-1 000141767 0247_ $$2pmid$$apmid:30442503 000141767 0247_ $$2ISSN$$a1470-2045 000141767 0247_ $$2ISSN$$a1474-5488 000141767 0247_ $$2altmetric$$aaltmetric:51102211 000141767 037__ $$aDKFZ-2018-02036 000141767 041__ $$aeng 000141767 082__ $$a610 000141767 1001_ $$0P:(DE-HGF)0$$aPlatzbecker, Uwe$$b0$$eFirst author 000141767 245__ $$aMeasurable residual disease-guided treatment with azacitidine to prevent haematological relapse in patients with myelodysplastic syndrome and acute myeloid leukaemia (RELAZA2): an open-label, multicentre, phase 2 trial. 000141767 260__ $$aLondon$$bThe Lancet Publ. Group$$c2018 000141767 3367_ $$2DRIVER$$aarticle 000141767 3367_ $$2DataCite$$aOutput Types/Journal article 000141767 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1550750651_27365 000141767 3367_ $$2BibTeX$$aARTICLE 000141767 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000141767 3367_ $$00$$2EndNote$$aJournal Article 000141767 520__ $$aMonitoring of measurable residual disease (MRD) in patients with advanced myelodysplastic syndromes (MDS) or acute myeloid leukaemia (AML) who achieve a morphological complete remission can predict haematological relapse. In this prospective study, we aimed to determine whether MRD-guided pre-emptive treatment with azacitidine could prevent relapse in these patients.The relapse prevention with azacitidine (RELAZA2) study is an open-label, multicentre, phase 2 trial done at nine university health centres in Germany. Patients aged 18 years or older with advanced MDS or AML, who had achieved a complete remission after conventional chemotherapy or allogeneic haemopoietic stem-cell transplantation, were prospectively screened for MRD during 24 months from baseline by either quantitative PCR for mutant NPM1, leukaemia-specific fusion genes (DEK-NUP214, RUNX1-RUNX1T1, CBFb-MYH11), or analysis of donor-chimaerism in flow cytometry-sorted CD34-positive cells in patients who received allogeneic haemopoietic stem-cell transplantation. MRD-positive patients in confirmed complete remission received azacitidine 75 mg/m2 per day subcutaneously on days 1-7 of a 29-day cycle for 24 cycles. After six cycles, MRD status was reassessed and patients with major responses (MRD negativity) were eligible for a treatment de-escalation. The primary endpoint was the proportion of patients who were relapse-free and alive 6 months after the start of pre-emptive treatment. Analyses were done per protocol. This trial is registered with ClincialTrials.gov, number NCT01462578, and finished recruitment on Aug 21, 2018.Between Oct 10, 2011, and Aug 20, 2015, we screened 198 patients with advanced MDS (n=26) or AML (n=172), of whom 60 (30%) developed MRD during the 24-month screening period and 53 (88%) were eligible to start study treatment. 6 months after initiation of azacitidine, 31 (58%, 95% CI 44-72) of 53 patients were relapse-free and alive (p<0·0001; one-sided binomial test for null hypothesis pexp≤0·3). With a median follow-up of 13 months (IQR 8·5-22·8) after the start of MRD-guided treatment, relapse-free survival at 12 months was 46% (95% CI 32-59) in the 53 patients who were MRD-positive and received azacitidine. In MRD-negative patients, 12-month relapse-free survival was 88% (95% CI 82-94; hazard ratio 6·6 [95% CI 3·7-11·8], p<0·0001). The most common (grade 3-4) adverse event was neutropenia, occurring in 45 (85%) of 53 patients. One patient with neutropenia died because of an infection considered possibly related to study treatment.Pre-emptive therapy with azacitidine can prevent or substantially delay haematological relapse in MRD-positive patients with MDS or AML who are at high risk of relapse. Our study also suggests that continuous MRD negativity during regular MRD monitoring might be prognostic for patient outcomes.Celgene Pharma, José Carreras Leukaemia Foundation, National Center for Tumor Diseases (NCT), and German Cancer Consortium (DKTK) Foundation. 000141767 536__ $$0G:(DE-HGF)POF3-317$$a317 - Translational cancer research (POF3-317)$$cPOF3-317$$fPOF III$$x0 000141767 588__ $$aDataset connected to CrossRef, PubMed, 000141767 7001_ $$0P:(DE-HGF)0$$aMiddeke, Jan Moritz$$b1 000141767 7001_ $$0P:(DE-HGF)0$$aSockel, Katja$$b2 000141767 7001_ $$aHerbst, Regina$$b3 000141767 7001_ $$aWolf, Dominik$$b4 000141767 7001_ $$aBaldus, Claudia D$$b5 000141767 7001_ $$aOelschlägel, Uta$$b6 000141767 7001_ $$aMütherig, Anke$$b7 000141767 7001_ $$aFransecky, Lars$$b8 000141767 7001_ $$aNoppeney, Richard$$b9 000141767 7001_ $$0P:(DE-HGF)0$$aBug, Gesine$$b10 000141767 7001_ $$aGötze, Katharina S$$b11 000141767 7001_ $$0P:(DE-He78)493c5fbf69f1b20df6f048712f3ad4a0$$aKrämer, Alwin$$b12$$udkfz 000141767 7001_ $$0P:(DE-He78)c741dc7f974390ad4310349f29aac40b$$aBochtler, Tilmann$$b13$$udkfz 000141767 7001_ $$aStelljes, Matthias$$b14 000141767 7001_ $$aGroth, Christoph$$b15 000141767 7001_ $$0P:(DE-HGF)0$$aSchubert, Antje$$b16 000141767 7001_ $$0P:(DE-HGF)0$$aMende, Marika$$b17 000141767 7001_ $$0P:(DE-HGF)0$$aStölzel, Friedrich$$b18 000141767 7001_ $$0P:(DE-HGF)0$$aBorkmann, Christine$$b19 000141767 7001_ $$0P:(DE-HGF)0$$aKubasch, Anne Sophie$$b20 000141767 7001_ $$0P:(DE-He78)ed7603cfd1904e27a05a53718a464eed$$avon Bonin, Malte$$b21$$udkfz 000141767 7001_ $$0P:(DE-HGF)0$$aServe, Hubert$$b22 000141767 7001_ $$aHänel, Mathias$$b23 000141767 7001_ $$aDührsen, Ulrich$$b24 000141767 7001_ $$0P:(DE-HGF)0$$aSchetelig, Johannes$$b25 000141767 7001_ $$0P:(DE-HGF)0$$aRöllig, Christoph$$b26 000141767 7001_ $$0P:(DE-HGF)0$$aKramer, Michael$$b27 000141767 7001_ $$0P:(DE-HGF)0$$aEhninger, Gerhard$$b28 000141767 7001_ $$0P:(DE-HGF)0$$aBornhäuser, Martin$$b29 000141767 7001_ $$0P:(DE-HGF)0$$aThiede, Christian$$b30$$eLast author 000141767 773__ $$0PERI:(DE-600)2035574-9$$a10.1016/S1470-2045(18)30580-1$$gp. S1470204518305801$$n12$$p1668-1679$$tThe lancet <London> / Oncology Oncology$$v19$$x1470-2045$$y2018 000141767 909CO $$ooai:inrepo02.dkfz.de:141767$$pVDB 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b0$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b1$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b2$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b10$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)493c5fbf69f1b20df6f048712f3ad4a0$$aDeutsches Krebsforschungszentrum$$b12$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)c741dc7f974390ad4310349f29aac40b$$aDeutsches Krebsforschungszentrum$$b13$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b16$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b17$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b18$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b19$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b20$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)ed7603cfd1904e27a05a53718a464eed$$aDeutsches Krebsforschungszentrum$$b21$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b22$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b25$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b26$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b27$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b28$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b29$$kDKFZ 000141767 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-HGF)0$$aDeutsches Krebsforschungszentrum$$b30$$kDKFZ 000141767 9131_ $$0G:(DE-HGF)POF3-317$$1G:(DE-HGF)POF3-310$$2G:(DE-HGF)POF3-300$$3G:(DE-HGF)POF3$$4G:(DE-HGF)POF$$aDE-HGF$$bGesundheit$$lKrebsforschung$$vTranslational cancer research$$x0 000141767 9141_ $$y2018 000141767 915__ $$0StatID:(DE-HGF)0200$$2StatID$$aDBCoverage$$bSCOPUS 000141767 915__ $$0StatID:(DE-HGF)0300$$2StatID$$aDBCoverage$$bMedline 000141767 915__ $$0StatID:(DE-HGF)0310$$2StatID$$aDBCoverage$$bNCBI Molecular Biology Database 000141767 915__ $$0StatID:(DE-HGF)0100$$2StatID$$aJCR$$bLANCET ONCOL : 2017 000141767 915__ $$0StatID:(DE-HGF)0600$$2StatID$$aDBCoverage$$bEbsco Academic Search 000141767 915__ $$0StatID:(DE-HGF)0030$$2StatID$$aPeer Review$$bASC 000141767 915__ $$0StatID:(DE-HGF)0199$$2StatID$$aDBCoverage$$bClarivate Analytics Master Journal List 000141767 915__ $$0StatID:(DE-HGF)0111$$2StatID$$aWoS$$bScience Citation Index Expanded 000141767 915__ $$0StatID:(DE-HGF)0150$$2StatID$$aDBCoverage$$bWeb of Science Core Collection 000141767 915__ $$0StatID:(DE-HGF)1110$$2StatID$$aDBCoverage$$bCurrent Contents - Clinical Medicine 000141767 915__ $$0StatID:(DE-HGF)9930$$2StatID$$aIF >= 30$$bLANCET ONCOL : 2017 000141767 9201_ $$0I:(DE-He78)L301-20160331$$kL301$$lDKTK Dresden$$x0 000141767 9201_ $$0I:(DE-He78)L501-20160331$$kL501$$lDKTK Frankfurt$$x1 000141767 9201_ $$0I:(DE-He78)G330-20160331$$kG330$$lKKE Molekulare Hämatologie/Onkologie$$x2 000141767 9201_ $$0I:(DE-He78)L101-20160331$$kL101$$lDKTK Heidelberg$$x3 000141767 9201_ $$0I:(DE-He78)L201-20160331$$kL201$$lDKTK Berlin$$x4 000141767 9201_ $$0I:(DE-He78)L701-20160331$$kL701$$lDKTK München$$x5 000141767 980__ $$ajournal 000141767 980__ $$aVDB 000141767 980__ $$aI:(DE-He78)L301-20160331 000141767 980__ $$aI:(DE-He78)L501-20160331 000141767 980__ $$aI:(DE-He78)G330-20160331 000141767 980__ $$aI:(DE-He78)L101-20160331 000141767 980__ $$aI:(DE-He78)L201-20160331 000141767 980__ $$aI:(DE-He78)L701-20160331 000141767 980__ $$aUNRESTRICTED