演題詳細

一般口演 / Oral Session

一般口演 74 (Oral Session 74) :貧血の臨床

print

日程
2013年10月13日(日)
時間
08:45 - 09:45
会場
第4会場 / Room No.4 (さっぽろ芸文館 3F 黎明)
座長・司会
亀岡 淳一 (Junichi Kameoka):1
1:東北大学 血液・免疫病学分野
 
前へ戻る

Outcome of off-guideline treatments for severe aplastic anemia: A single center study

演題番号 : OS-3-15

中崎 久美 (Kumi Nakazaki):1、南谷 泰仁 (Yasuhito Nannya):1、黒川 峰夫 (Mineo Kurokawa):1

1:Department Hematology and Oncology, The University of Tokyo

 

Guidelines recommend hematopoietic stem cell transplantation and ATG-based immunosuppressive therapy as the first line treatment for severe aplastic anemia (AA) cases, however, some cases are not tolerant to these intense regimens. In this study, we explored the efficacy of alternative treatments applied for such patients. Thirty-two patients (18 males and 14 females) of AA newly diagnosed from January 2008 to February 2013 at our institution were enrolled. Median age was 59 (range, 17 - 90). Median follow-up period was 22 months from diagnosis. Eleven cases (7 cases of stage I, and 4 of 6 stage II cases) did not receive any interventions. Seven of 21 cases with intervention (4 stage III, 2 stage IV, and 1 stage V case, respectively) had the therapies other than recommended ones due to concurrent diseases (including two cases of cancer, one of infection) and age. Anabolic steroids were administered to 2 cases, cyclosporine to 3, and both of them to 1. The other one received supportive care only. These seven and the remaining fourteen cases receiving the standard therapy had no significant difference in overall survival, although the standard group showed better survival (p = 0.17). Two and six cases (14% and 43%) achieved complete and partial response (CR, PR) in this group, and two (29%) achieved PR in the group of alternative therapies. Response (CR + PR) rates were not significantly different (p = 0.36). In conclusion if the recommended therapy to AA is not feasible, indication of other treatments including cyclosporine and anabolic steroids would be a practical option.

前へ戻る