{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T09:41:29Z","timestamp":1770975689043,"version":"3.50.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The objective of this real-world cohort study was to evaluate the efficacy and safety of decitabine versus conventional chemotherapy in the maintenance therapy (MT) of patients with acute myeloid leukemia (AML).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 156 consecutive patients diagnosed with AML at our center. All patients achieved complete remission (CR) after 1\u20132 courses of induction therapy, followed by consolidation with high-dose cytarabine (HiDAC). MT was administered using either decitabine or conventional chemotherapy, while patients who did not receive maintenance served as controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      MT significantly improved both relapse-free survival (RFS) and overall survival (OS) in AML patients. However, no significant difference was observed between decitabine and conventional chemotherapy. MT notably prolonged both RFS and OS in the cytogenetic intermediate-risk group, patients without\n                      <jats:italic>FLT3<\/jats:italic>\n                      -ITD mutations, and those achieving CR after one course of induction therapy. The benefits of MT were not influenced by the European Leukemia Net (ELN) risk category, measurable residual disease (MRD) status, or the number of HiDAC courses. Compared with chemotherapy, decitabine maintenance significantly improved RFS and OS in patients who received 3\u20134 courses of treatment. Additionally, the incidence of adverse reactions was significantly lower in the decitabine group than in the chemotherapy arm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MT with either decitabine or chemotherapy can improve outcomes of AML patients in this real-world cohort. Decitabine maintenance exhibits better tolerability compared with chemotherapy and enhances survival in specific patient subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1753030","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T08:34:37Z","timestamp":1770971677000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of maintenance with decitabine or chemotherapy in a real-world cohort of patients with acute myeloid leukemia"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhi-Feng","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Hematology, The First Hospital of Jilin University","place":["Changchun, China"]},{"name":"Key Laboratory of Hematology Precision Medicine of Jilin Province, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Qi","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Hospital of Jilin University","place":["Changchun, China"]},{"name":"Key Laboratory of Hematology Precision Medicine of Jilin Province, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye-Hui","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Hospital of Jilin University","place":["Changchun, China"]},{"name":"Key Laboratory of Hematology Precision Medicine of Jilin Province, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Hospital of Jilin University","place":["Changchun, China"]},{"name":"Key Laboratory of Hematology Precision Medicine of Jilin Province, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiu-Ju","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Hospital of Jilin University","place":["Changchun, China"]},{"name":"Key Laboratory of Hematology Precision Medicine of Jilin Province, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Liang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Hospital of Jilin University","place":["Changchun, China"]},{"name":"Key Laboratory of Hematology Precision Medicine of Jilin Province, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Hospital of Jilin University","place":["Changchun, China"]},{"name":"Key Laboratory of Hematology Precision Medicine of Jilin Province, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su-Jun","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Hospital of Jilin University","place":["Changchun, China"]},{"name":"Key Laboratory of Hematology Precision Medicine of Jilin Province, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1038\/leu.2016.252","article-title":"Maintenance therapy with decitabine in younger adults with acute myeloid leukemia in first remission: a phase 2 cancer and leukemia group B study (CALGB 10503)","volume":"31","author":"Blum","year":"2017","journal-title":"Leukemia"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2993","DOI":"10.1200\/JCO.19.03345","article-title":"Sorafenib maintenance after allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia with FLT3-Internal tandem duplication mutation (SORMAIN)","volume":"38","author":"Burchert","year":"2020","journal-title":"J. Clinical Oncology Official Journal Am. Soc. Clin. Oncol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1020402","DOI":"10.3389\/fpubh.2022.1020402","article-title":"Spatial distribution, regional differences, and dynamic evolution of the medical and health services supply in China","volume":"10","author":"Chen","year":"2022","journal-title":"Front. Public Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s40290-022-00456-6","article-title":"Real-world evidence: a primer","volume":"37","author":"Dang","year":"2023","journal-title":"Pharm. Medicine"},{"key":"B5","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1056\/NEJMoa2012971","article-title":"Azacitidine and venetoclax in previously untreated acute myeloid leukemia","volume":"383","author":"DiNardo","year":"2020","journal-title":"N. Engl. Journal Medicine"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1182\/blood.2022016867","article-title":"Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN","volume":"140","author":"D\u00f6hner","year":"2022","journal-title":"Blood"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.1016\/S0140-6736(23)00464-6","article-title":"Quizartinib plus chemotherapy in newly diagnosed patients with FLT3-internal-tandem-duplication-positive acute myeloid leukaemia (QuANTUM-First): a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"401","author":"Erba","year":"2023","journal-title":"Lancet London, Engl."},{"key":"B8","doi-asserted-by":"publisher","first-page":"5857","DOI":"10.1182\/bloodadvances.2022008632","article-title":"Enasidenib as maintenance following allogeneic hematopoietic cell transplantation for IDH2-mutated myeloid malignancies","volume":"6","author":"Fathi","year":"2022","journal-title":"Blood Advances"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1158\/1078-0432.CCR-23-0182","article-title":"Multicenter phase I trial of ivosidenib as maintenance treatment following allogeneic hematopoietic cell transplantation for IDH1-Mutated acute myeloid leukemia","volume":"29","author":"Fathi","year":"2023","journal-title":"Clin. Cancer Research An Official Journal Am. Assoc. Cancer Res."},{"key":"B10","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1182\/blood-2019-129876","article-title":"Maintenance decitabine (DAC) improves disease-free (DFS) and overall survival (OS) after intensive therapy for acute myeloid leukemia (AML) in older adults, particularly in FLT3-ITD-Negative patients: ECOG-ACRIN (E-A) E2906 randomized study","volume":"134","author":"Foran","year":"2019","journal-title":"Blood"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e0328526","DOI":"10.1371\/journal.pone.0328526","article-title":"Hematological malignancy burden in mainland China and Taiwan from 1990 to 2021 and decadal projections: insights from the global burden of disease study 2021","volume":"20","author":"Fu","year":"2025","journal-title":"PloS One"},{"key":"B12","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1182\/bloodadvances.2023012120","article-title":"Prophylactic maintenance with venetoclax\/azacitidine after reduced-intensity conditioning allogeneic transplant for high-risk MDS and AML","volume":"8","author":"Garcia","year":"2024","journal-title":"Blood Advances"},{"key":"B13","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/ajh.27583","article-title":"Maintenance therapy in AML: what is the future potential?","volume":"100","author":"Goulart","year":"2025","journal-title":"Am. Journal Hematology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2753","DOI":"10.1182\/blood.2021013626","article-title":"Update on MRD in acute myeloid leukemia: a consensus document from the european LeukemiaNet MRD working party","volume":"138","author":"Heuser","year":"2021","journal-title":"Blood"},{"key":"B15","doi-asserted-by":"publisher","first-page":"4696","DOI":"10.1038\/s41388-022-02455-y","article-title":"Decitabine enhances targeting of AML cells by NY-ESO-1-specific TCR-T cells and promotes the maintenance of effector function and the memory phenotype","volume":"41","author":"Kang","year":"2022","journal-title":"Oncogene"},{"key":"B16","doi-asserted-by":"publisher","first-page":"331","DOI":"10.14744\/nci.2021.42800","article-title":"Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: real experience data","volume":"9","author":"Karakus","year":"2022","journal-title":"North. Clinics Istanbul"},{"key":"B17","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s40164-020-00178-y","article-title":"Effects of decitabine on allogeneic immune reactions of donor lymphocyte infusion via activation of dendritic cells","volume":"9","author":"Kwon","year":"2020","journal-title":"Exp. Hematology & Oncology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1766","DOI":"10.1200\/JCO.23.02474","article-title":"Gilteritinib as post-transplant maintenance for AML with internal tandem duplication mutation of FLT3","volume":"42","author":"Levis","year":"2024","journal-title":"J. Clinical Oncology Official Journal Am. Soc. Clin. Oncol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1716","DOI":"10.1182\/blood-2022-157326","article-title":"Randomized phase II study to assess the role of nivolumab as single agent to eliminate minimal residual disease and maintain remission in acute myelogenous leukemia (AML) patients after chemotherapy (NCI9706 protocol; REMAIN trial)","volume":"140","author":"Liu","year":"2022","journal-title":"Blood"},{"key":"B20","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12943-023-01768-0","article-title":"Epigenetic reprogramming of Runx3 reinforces CD8+ T-cell function and improves the clinical response to immunotherapy","volume":"22","author":"Liu","year":"2023","journal-title":"Mol. Cancer"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1182\/blood.2024024861","article-title":"Nanobody-based naturally selected CD7-targeted CAR-T therapy for acute myeloid leukemia","volume":"145","author":"Lu","year":"2025","journal-title":"Blood"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1038\/s41409-020-01153-1","article-title":"Midostaurin after allogeneic stem cell transplant in patients with FLT3-internal tandem duplication-positive acute myeloid leukemia","volume":"56","author":"Maziarz","year":"2021","journal-title":"Bone Marrow Transplantation"},{"key":"B23","doi-asserted-by":"publisher","first-page":"5580","DOI":"10.1182\/bloodadvances.2020002544","article-title":"A phase 3 randomized study of 5-azacitidine maintenance vs observation after transplant in high-risk AML and MDS patients","volume":"4","author":"Oran","year":"2020","journal-title":"Blood Advances"},{"key":"B24","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1038\/s41408-021-00453-z","article-title":"Nivolumab maintenance in high-risk acute myeloid leukemia patients: a single-arm, open-label, phase II study","volume":"11","author":"Reville","year":"2021","journal-title":"Blood Cancer Journal"},{"key":"B25","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1002\/ajh.26496","article-title":"Activity of decitabine as maintenance therapy in core binding factor acute myeloid leukemia","volume":"97","author":"Senapati","year":"2022","journal-title":"Am. Journal Hematology"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2289","DOI":"10.3324\/haematol.2022.281810","article-title":"Maintenance therapy in acute myeloid leukemia: advances and controversies","volume":"108","author":"Senapati","year":"2023","journal-title":"Haematologica"},{"key":"B27","volume-title":"ISCN 2013: an international system for human cytogenetic nomenclature","author":"Shaffer","year":"2013"},{"key":"B28","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1002\/ajh.27625","article-title":"Acute myeloid leukemia: 2025 update on diagnosis, risk-stratification, and management","volume":"100","author":"Shimony","year":"2025","journal-title":"Am. Journal Hematology"},{"key":"B29","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.21871","article-title":"Cancer statistics","volume":"75","author":"Siegel","year":"2025","journal-title":"CA A Cancer Journal Clinicians"},{"key":"B30","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1056\/NEJMoa1614359","article-title":"Midostaurin plus chemotherapy for acute myeloid leukemia with a FLT3 mutation","volume":"377","author":"Stone","year":"2017","journal-title":"N. Engl. Journal Medicine"},{"key":"B31","doi-asserted-by":"publisher","first-page":"24970","DOI":"10.18632\/oncotarget.23873","article-title":"Mutational spectrum of acute myeloid leukemia patients with double CEBPA mutations based on next-generation sequencing and its prognostic significance","volume":"9","author":"Su","year":"2018","journal-title":"Oncotarget"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e22137","DOI":"10.1002\/ddr.22137","article-title":"CALCRL knockdown suppresses cancer stemness and chemoresistance in acute myeloid leukemia with FLT3-ITD and DNM3TA-R882 double mutations","volume":"85","author":"Tang","year":"2024","journal-title":"Drug Development Research"},{"key":"B33","doi-asserted-by":"publisher","first-page":"2963","DOI":"10.1200\/JCO.22.02120","article-title":"Measurable residual disease and fusion partner independently predict survival and relapse risk in childhood KMT2A-Rearranged acute myeloid leukemia: a study by the international berlin-frankfurt-m\u00fcnster study group","volume":"41","author":"van Weelderen","year":"2023","journal-title":"J. Clinical Oncology Official Journal Am. Soc. Clin. Oncol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1016\/S1470-2045(20)30455-1","article-title":"Sorafenib maintenance in patients with FLT3-ITD acute myeloid leukaemia undergoing allogeneic haematopoietic stem-cell transplantation: an open-label, multicentre, randomised phase 3 trial","volume":"21","author":"Xuan","year":"2020","journal-title":"Lancet Oncol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s12964-022-00956-7","article-title":"Potential role of autophagy induced by FLT3-ITD and acid ceramidase in acute myeloid leukemia chemo-resistance: new insights","volume":"20","author":"Zalpoor","year":"2022","journal-title":"Cell Communication Signaling CCS"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1002\/ajh.26317","article-title":"Improved survival for young acute leukemia patients following a new donor hierarchy for allogeneic hematopoietic stem cell transplantation: a phase III randomized controlled study","volume":"96","author":"Zhang","year":"2021","journal-title":"Am. Journal Hematology"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1753030\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T08:34:38Z","timestamp":1770971678000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1753030\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":36,"alternative-id":["10.3389\/fphar.2026.1753030"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1753030","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]},"article-number":"1753030"}}