Treatment of Acute Leukemia Relapse After Allotransplantation

Treatment of Relapsed Acute Leukemia After Allogeneic Stem Cell Transplantation: Disease Stabilization Through Chemotherapy, Immunomodulatory Treatment and Immunotherapy

Patients with relapse of acute leukemia often only receive supportive therapy. Our hypothesis is that a combination therapy can stabilize the disease for patients with early relapse after allogeneic stem cell transplantation. The investigators will combine 5-azacitidine 100 mg daily subcutaneously (days 1-3), valproic acid (continuous therapy from day 1), All-trans retinoic acid (days 1-14) and hydroxurea (continuous treatment from day 15 of first cycle. Azacitidine and ATRA can be repeated with 5 weeks intervals, donor leukocyte infusions on day 10 is allowed from the second cycle.

Inclusion Criteria:

• AML relapse within one year after transplantation
• Blood and marrow sampling being possible
• Expected survival at least 4 weeks
• No expected drug interactions
• Informed consent possible

Exclusion Criteria:

• Intolerance to any study drug
• Serious kidney or liver disease
• Informed consent not possible
• Previous pancreatitis