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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1811939
Original Article

Role of Maintenance Therapy with Decitabine in Acute Myeloid Leukemia in First Remission: A Prospective Interventional Study from a Tertiary Care Center in Eastern India

Authors

  • Subham Bhattacharya 

    1   Department of Hematology, Nil Ratan Sarkar Medical College and Hospital, Kolkata, West Bengal, India

  • Apurba Banerjee 

    1   Department of Hematology, Nil Ratan Sarkar Medical College and Hospital, Kolkata, West Bengal, India

  • Tuphan Kanti Dolai 

    1   Department of Hematology, Nil Ratan Sarkar Medical College and Hospital, Kolkata, West Bengal, India

  • Sanjoy Kumar Sadhukhan 

    2   Department of Epidemiology, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
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Abstract

Introduction

Major advances in the diagnostic methodologies and technological progress have led to successful development of many targeted agents in the management of acute myeloid leukemia (AML). At present, standard of care of AML postremission depends on the molecular risk stratification of the disease. Despite incorporation of newer agents with chemotherapy, relapse remains a major problem. To address this unmet need, many investigators have used hypomethylating and other targeted drugs as maintenance after remission induction in AML in different clinical studies with variable results.

Objectives

We conducted this study to determine the efficacy of maintenance decitabine in AML after remission and to assess its side effects.

Materials and Methods

This is a prospective interventional study. After considering the inclusion and exclusion criteria, patients with a diagnosis of AML were given 3 + 7 induction. All adverse risk patients were counseled for allogeneic hematopoietic stem cell transplantation and removed from the study if they opted for that. After documenting remission, patients were given three high-dose cytarabine (HIDAC) as consolidation. Those who remain on remission after third HIDAC were started on decitabine maintenance at 12 weeks' interval. A total of 20 patients were included. They were followed up at 3 monthly intervals by complete blood count, peripheral blood smear, and bone marrow aspiration during maintenance. Disease-free survival (DFS) and overall survival (OS) were calculated and compared with historical control. Toxicity and side effects of decitabine were also assessed.

Results

At a median follow-up of 29 months, the median DFS and OS were 20.5 and 27.5 months, respectively. Seven patients experienced grade 3 and 1 patient grade 4 hematological adverse events. One patient died due to febrile neutropenia.

Conclusion

Decitabine may be considered as safe and effective maintenance agent in AML after achieving first remission.

Keywords

non-M3 AML - decitabine - maintenance - disease-free and overall survival

Patient Consent

Patient consent has been obtained.


Place of study -Hematology department, Nil Ratan Sirkar Medical College & Hospital (NRSMCH).




Publikationsverlauf

Artikel online veröffentlicht:
25. September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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