Abstract
Following publication of the ALLOZITHRO trial, the FDA released a safety announcement warning that azithromycin should not be given long-term to prevent BOS in patients with a blood or lymph cancer who have undergone allogeneic HSCT. Our site typically initiated azithromycin when patients were diagnosed with BOS post-transplant rather than empirically as prevention. The purpose of our study was to discern whether the use of azithromycin at the time of diagnosis of BOS increased risk of disease relapse in patients who received an allogeneic HSCT for malignant disease. We retrospectively reviewed 432 patients in 3 cohorts: Cohort (1) patients who received greater than or equal to 2 weeks of azithromycin therapy (n = 98); Cohort (2) patients who received azithromycin therapy for less than 2 weeks (n = 63); and Cohort (3) patients who never received azithromycin therapy (n = 271). Neither patients in Cohort 1 (HR 0.44; 95% CI, 0.12–1.53, P = 0.19) nor Cohort 2 (HR 0.66; 95% CI, 0.2–2.19, P = 0.49) were associated with an increased risk of relapse when compared to those who had never received azithromycin. Our data indicate that the prolonged use of azithromycin after allogeneic HSCT is not associated with an increased rate of hematologic relapse.
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This work was supported by the Mayo Midwest Pharmacy Research Committee (MMPRC).
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No competing interests to report that are relevant to this article. Dr. Shah is a consultant for Dren Bio and Dr. Taraba receives research support from Pfizer and is on the advisory board for Daiichi Sankyo; however none of these relationships are related to this publication.
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Kutzke, J.L., Merten, J.A., Taraba, J.L. et al. Risk of relapse in patients receiving azithromycin after allogeneic HSCT. Bone Marrow Transplant 56, 960–962 (2021). https://doi.org/10.1038/s41409-020-01095-8
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DOI: https://doi.org/10.1038/s41409-020-01095-8
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