演題詳細

ポスター / Poster

ポスター 6 (Poster 6) :AML:発症・治療・その他

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
安部 明弘 (Akihiro Abe):1
1:藤田保健衛生大学 血液内科
 
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Prolonged survival after 3rd allogeneic hematopoietic stem cell transplantation in an AML patient

演題番号 : PS-1-43

李 碩瑛 (Suk-Young Lee):1、栗田 尚樹 (Naoki Kurita):1、関 正則 (Masanori Seki):1、横山 泰久 (Yasuhisa Yokoyama):1、鈴木(塙) 幸恵 (Sachie Suzuki-Hanawa):1、坂田(柳元) 麻実子 (Mamiko Sakata-Yanagimoto):1、小原 直 (Naoshi Obara):1、鈴川 和己 (Kazumi Suzukawa):1、長谷川 雄一 (Yuichi Hasegawa):1、千葉 滋 (Shigeru Chiba):1

1:Department of Hematology, University of Tsukuba, Tsukuba, Ibaraki, Japan

 

A 49 y/o female was diagnosed as myelodysplastic syndrome (MDS) and developed to acute myeloid leukemia with myelodysplasia-related changes (AML-MRC). She received 1st allogeneic hematopoietic stem cell transplantation (allo-HSCT) from an MUD, with TBI and cyclophophamide as a conditioning regimen. The AML relapsed, and she received cord blood (CB) for 2nd allo-HSCT 16 months after the 1st one, with iv busulfan and cyclophosphamide. The AML relapsed again, and she received 3rd allo-HSCT 25 months after the 2nd one, when she was 53 y/o. At the 3rd transplantation, she was enrolled in a clinical trial with intra-bone marrow injection of CB cells. The graft was 5/6 HLA (A, B, DR)- matched, sex mismatched, and ABO mismatched unrelated CB with 3.2*107 /kg nucleated and 1*105 /kg CD34-positive cells. Conditioning regimen consisted of fludarabine, ranimustine, and melphalan, and tacrolimus alone was prescribed as graft-versus-host disease (GVHD) prophylaxis. Donor cells accounted for > 95% of the bone marrow nucleated cells at post-transplant day 14, and neutrophil engraftment and bone marrow remission were confirmed on day 16 and 28, respectively. Despite complications such as grade II acute GVHD and sepsis, she became independent of transfusion and is keeping remission for 10 months with almost normal blood counts and an excellent QOL. This is a successful case of individually adjusted approach to treat a relapsed and refractory AML patient.

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