演題詳細

ポスター / Poster

ポスター 9 (Poster 9) :CML:臨床1 (CML:Clinical Research 1)

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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
田中 英夫 (Hideo Tanaka):1
1:広島市立安佐市民病院 血液内科
 
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Effect of graft sources on allo-SCT outcome in adults with CML in the era of Imatinib

演題番号 : PS-1-60

大橋 一輝 (Kazuteru Ohashi):1、長村 登紀子 (Tokiko Nagamura-Inoue):2、長村 文孝 (Fumitaka Nagamura):3、東條 有伸 (Arinobu Tojo):4、宮村 耕一 (Koichi Miyamura):5、石川 淳 (Jun Ishikawa):6、森島 泰雄 (Yasuo Morishima):7、森 毅彦 (Takehiko Mori):8、熱田 由子 (Yoshiko Atsuta):9、坂巻 壽 (Hisashi Sakamaki):1

1:Hematology Division, Tokyo Metro Komagome Hospital、2:Department of Cell Processing/Transfusion, Research Hospital, The Institute of Medical Science, The University of Tokyo、3:Division of Clinical Trial Safety Management, Research Hospital, The Institute of Medical Science, The University of Tokyo、4:Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo、5:Department of Hematology, Japanese Red Cross Nagoya Daiichi Hospital、6:Hematology&Oncology,Osaka Medical center for cancer and cardiovascular diseases、7:Division of Epidemiology/Prevention, Aichi Cancer Center Research Institute、8:Division of Hematology, Department of Medicine, Keio University School of Medicine、9:Department of HSCT Data Management / Biostatistics, Nagoya University Graduate School of Medicine

 

Background: TKIs have largely supplanted allo-SCT as first-line therapy for CML. Nevertheless, a certain number of patients eventually undergo allo-SCT even in the era of TKIs, raising the question of whether current graft selection practices are appropriate.Methods: We used Cox regression to retrospectively compare OS and other outcomes for rBMT, rPBSCT, uBMT, and uCBT in patients aged 20 years or over. Data were available on 1,062 patients with CML who underwent allo-SCT during the last decade in Japan. Of them, 414 patients had a clear history of pre-transplant imatinib (IM) use. The disease status of the 1,062 patients with CML was as follows: CP1 (n=531), CP2-AP (n=342) and BC (n=189). Graft sources (GS) were rBMT (n=205), uBMT (n=507), rPBSCT (n=226) or uCBT (n=124).Findings: Three-year OS for patients in CP1, CP2-AP and BC was 70.6%, 58.9% and 26.9%, respectively. The patients in CP1 who were treated by rBMT had significantly better OS. Three-year OS with rBMT was as high as 84.4%, while that from rPBSCT, uBMT and uCBT was 70.0%, 64.4% and 48.0%, respectively. For patients in the advanced phase of CML beyond CP1, GS could have no significant impact on OS. Multivariate analysis identified rBMT, younger age and no ABO mismatch as the factors for better OS in CP1. Improved OS in CP2-AP was seen with younger age. In BC, pre-transplant IM was the only factor associated with better OS.Interpretation: Our results support the use of rBMT for adult patients in CP1, but the superiority of rPBSCT in the advanced phase of CML was not confirmed in our large cohort.

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