演題詳細

一般口演 / Oral Session

一般口演 7 (Oral Session 7) :MDS:臨床 1

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日程
2013年10月11日(金)
時間
09:30 - 10:30
会場
第6会場 / Room No.6 (ロイトン札幌 2F エンプレス)
座長・司会
南谷 泰仁 (Yasuhito Nannya):1
1:東京大学 血液・腫瘍内科
 
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Impact of therapy with azacitidine alone before allogeneic stem cell transplantation for MDS

演題番号 : OS-1-34

押川 学 (Gaku Oshikawa):1、新谷 直樹 (Naoki Shingai):1、池川 俊太郎 (Shuntaro Ikegawa):1、金政 佑典 (Yusuke Kanemasa):1、高橋 幸江 (Yukie Takahashi):1、吉岡 康介 (Kosuke Yoshioka):1、青木 淳 (Jun Aoki):1、森 甚一 (Jinichi Mori):1、安永 愛 (Megumi Yasunaga):1、梅澤 佳央 (Yoshihiro Umezawa):1、小林 武 (Takeshi Kobayashi):1、土岐 典子 (Noriko Doki):1、垣花 和彦 (Kazuhiko Kakihana):1、大橋 一輝 (Kazuteru Ohashi):1、坂巻 壽 (Hisashi Sakamaki):1

1:Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital

 

Although allogeneic hematopoietic stem cell transplantation (HSCT) remains the only curative therapeutic approach in patients with myelodysplastic syndrome (MDS), relapse after HSCT remains a problem. Pretransplantation cytoreduction with induction chemotherapy has been used to reduce relapse rates but is associated with significant toxicity and mortality. To investigate the impact of azacitidine before HSCT for MDS, we retrospectively reviewed outcomes in 17 patients who were treated with azacitidine (AZA) alone before HSCT for MDS in our institution, and compared with results in 21 patients who received HSCT for MDS but not pre-transplant AZA treatment as historical control. Patients received azacitidine for a median of four cycles (range 1-13). The overall response rate (complete/partial remission/marrow complete remission/hematological improvement) in the AZA alone group before HSCT was 35 %. The estimated 1-year overall survival (OS) was 62 % in the AZA alone group and 71 % in the no AZA group (P=0.31). The estimated 1-year relapse rate was 21 % in the AZA alone group and 14 % in the no AZA group (P=0.82). Only 4 patients (24 %) in the AZA alone group developed grades II to IV acute GVHD as compared to 11 patients (52 %) in the no AZA group (P=0.1). Although the present study was small, retrospective and nonrandomized, our results showed that pre-HSCT therapy with AZA alone may allow for similar post-HSCT outcomes to the conventional pre-HSCT therapy for MDS, and reduce the morbidity of acute GVHD.

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