{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:16:21Z","timestamp":1784200581755,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Allogeneic hematopoietic stem cell transplantation (allo\u2010HSCT) remains the sole curative option for myeloid malignancies, though high toxicity from conditioning regimens and complications like graft\u2010versus\u2010host disease (GVHD) limit its success. The potential benefit of incorporating decitabine (DAC) into conditioning regimens for acute myeloid leukemia (AML) and intermediate\u2010to\u2010high\u2010risk myelodysplastic syndromes (MDS) patients in remission remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective, single\u2010center study analyzing data from January 2016 to December 2020 at the First Affiliated Hospital of Ningbo University with a median follow\u2010up of 45.05 months (range, 1\u201396 months). Outcomes were compared between patients receiving DAC+HSCT versus HSCT alone, with primary endpoints of 5\u2010year overall survival (OS), progression\u2010free survival (PFS), and relapse rate. Secondary analyses examined outcomes by remission status (CR1 vs. others) and age subgroups (&lt;\u200931.5\u2009years). Immune cell subsets (CD3\u2212CD56+ NK cells) were evaluated for GVHD correlation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The DAC+HSCT group exhibited 5\u2010year OS of 51.9% and PFS of 46.1%, compared to 67% OS and 56.5% PFS in the HSCT\u2010only group. The 5\u2010year relapse rate was 16.9% for DAC+HSCT versus 23.2% for HSCT alone. DAC did not significantly improve outcomes in complete remission (CR1) patients but improved OS and PFS in patients under 31.5\u2009years of age. Elevated CD3\u2212CD56+ NK cells in the DAC+HSCT group were associated with higher incidence of severe acute GVHD (aGVHD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While DAC conditioning did not provide overall survival benefit for AML\/MDS patients undergoing allo\u2010HSCT, it improved outcomes in younger individuals (&lt;\u200931.5\u2009years). Higher NK cell proportions may serve as a potential biomarker for early aGVHD intervention, warranting further investigation into risk\u2010stratified conditioning approaches.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.71081","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T10:28:26Z","timestamp":1753266506000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Decitabine Conditioning on Allo\u2010<scp>HSCT<\/scp> Outcomes in <scp>AML<\/scp> and Intermediate\u2010to\u2010High\u2010Risk <scp>MDS<\/scp> Patients in Remission"],"prefix":"10.1002","volume":"14","author":[{"given":"Shuling","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Hematology The First Affiliated Hospital of Ningbo University  Ningbo China"},{"name":"Health Science Center, Ningbo University  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanchuan","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Hematology Lianyungang Second People's Hospital  Lianyungang Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengfa","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hematology The First Affiliated Hospital of Ningbo University  Ningbo China"},{"name":"Health Science Center, Ningbo University  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology The First Affiliated Hospital of Ningbo University  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Hematology The First Affiliated Hospital of Ningbo University  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7273-5742","authenticated-orcid":false,"given":"Guifang","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Hematology The First Affiliated Hospital of Ningbo University  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8596-9300","authenticated-orcid":false,"given":"Ping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology The First Affiliated Hospital of Ningbo University  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/cas.15048"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-12-257253"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-03-0687"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1605949"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-015-2547-0"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22376"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2021.1891230"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-022-01645-2"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.3361"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2016.02.003"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2019.09.001"},{"issue":"12","key":"e_1_2_12_13_1","first-page":"1035","article-title":"Preliminary Study on Immunological Changes and Clinical Significance of Decitabine Treatment for Relapsed Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation","volume":"41","author":"Cao X. H.","year":"2020","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-021-01238-5"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000030644"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2017.1390235"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-06-2762"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.844937"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-06-790204"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T06:02:30Z","timestamp":1754460150000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.71081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":18,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/cam4.71081"],"URL":"https:\/\/doi.org\/10.1002\/cam4.71081","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71081"}}