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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The impact of IPSS-R at diagnosis of MDS for survival after alloSCT

演題番号 : OS-1-35

宮尾 康太郎 (Kotaro Miyao):1、三宅 奏衣 (Kanae Miyake):1、堺 寿保 (Toshiyasu Sakai):1、津下 奈都子 (Natsuko Tsushita):1、酒村 玲央奈 (Reona Sakemura):1、加藤 智則 (Tomonori Kato):1、新美 圭子 (Keiko Niimi):1、小野 芳孝 (Yoshitaka Ono):1、澤 正史 (Masashi Sawa):1

1:Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan

 

[Background] MDS is a disease group of great diversity. Allogenic stem-cell transplantation (alloSCT) is the only curable therapy. But the risk factors, suitable conditioning regimens and suitable treatment before alloSCT are not clear. [Patients and Methods] To investigate the impact of disease risk factors and disease status on outcome after alloSCT, we retrospectively analyzed 25 MDS patients who underwent alloSCT in our hospital. The FAB classifications were as follows: refractory anemia (RA) (=17), RA with excess blast (RAEB) (=7), RAEB-t (=1). The revised IPSS (IPSS-R) were as follows: low (=0), intermediate (=5), high (=7), very high (=12). [Results] Median age was 59 (38-67). Overall survival (OS) at 1 year were 49.3%. With subgroup analysis of OS at 1year, male (38.2% p=0.029), IPSS-R very high (0.00% p<0.001) and very poor cytogenetics (13.3% p=0.005) were poor prognostic factors. On the other hand, interval from diagnosis to alloSCT, blast counts at alloSCT, conditioning regimens, donor sources, performance status and chemotherapy history had no significant impact on OS. Four patients received Azacitidine (Aza) before alloSCT and their OS tend to be better than others (at 1 year: 75.0%). With a multivariate analysis, IPSS-R very high was associated with significantly worse OS with hazard ratio of 23.81 (95%CI: 2.825-200 p=0.004). [Conclusion] Patients with IPSS-R very high had poor survival even if they were young, in good disease status before alloSCT and performed alloSCT from appropriate donor. Aza may improve the outcome. We need prospective studies.

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