{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:43:59Z","timestamp":1784735039491,"version":"3.55.0"},"reference-count":83,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Azacitidine (AZA) either single-agent or with donor lymphocytes infusions (DLI) has been used as a salvage treatment for acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) relapsing after allogeneic hematopoietic stem cell transplantation (HSCT). To date, the majority of data come from patients relapsed after HSCT from full-matched donors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We report a multicenter, collaborative, retrospective analysis of 71 patients with hematologic ( n\u2009=\u200940, 56%) and molecular relapse ( n\u2009=\u200931, 44%) of myeloid neoplasms after HSCT from alternative donors (mismatched unrelated, n\u2009=\u200939, 55%; haploidentical, n\u2009=\u200929, 41%) consecutively treated at three European centers with AZA\u2009\u00b1\u2009DLI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Median time from HSCT to relapse was 9\u2009months. Additional DLI were given to 33 patients (46%). After a median of four cycles, overall response rate (ORR) was 49% and complete response (CR) rate was 38%. CR lasted for a median of 17\u2009months (range 5\u201389\u2009months). Median follow-up in the entire cohort was 11\u2009months (range 1\u2013115\u2009months). Event-free survival (EFS) and overall survival (OS) at 1\u2009year were 26% and 53%, respectively. Treatment of molecular relapse granted higher CR rate (65% versus 15%; p\u2009 =\u20090.0001), 1-year EFS (43% versus 13%; p\u2009=\u20090.006), and 1-year OS (79% versus 34%; p\u2009&lt;\u20090.001) compared to hematologic relapses. Addition of DLI resulted in significantly higher responses and longer 1-year EFS and OS (Mantel\u2013Byar test, p\u2009=\u20090.004 and p\u2009 =\u20090.002, respectively). When applied to our cohort, the APSS-R score confirmed its ability to stratify patients into distinct prognostic groups with significantly different response rates ( p\u2009 =\u20090.0005) and survival ( p\u2009&lt;\u20090.0001). Treatment was well tolerated, with the incidence of late acute and chronic graft-versus-host disease of 27% and 18%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>AZA\u2009\u00b1\u2009DLI proved feasible and effective in AML and MDS relapsing after HSCT from alternative donors. Despite modest efficacy among hematologic relapses, pre-emptive treatment with AZA\u2009\u00b1\u2009DLI fared better in molecular relapse. Additional DLI contributed to improving efficacy and ensuring longer survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20406207221090882","type":"journal-article","created":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T02:18:47Z","timestamp":1655518727000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Azacitidine and donor lymphocytes infusions in acute myeloid leukemia and myelodysplastic syndrome relapsed after allogeneic hematopoietic stem cell transplantation from alternative donors"],"prefix":"10.1177","volume":"13","author":[{"given":"Carmine","family":"Liberatore","sequence":"first","affiliation":[{"name":"Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa Lupo","family":"Stanghellini","sequence":"additional","affiliation":[{"name":"Haematology 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