演題詳細

一般口演 / Oral Session

【E】一般口演 21 (Oral Session 21) :Hematopoietic Cell Transplantation

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日程
2013年10月11日(金)
時間
14:25 - 15:25
会場
第5会場 / Room No.5 (さっぽろ芸文館 3F 清流)
座長・司会
石山 謙 (Ken Ishiyama):1
1:Div. Hematology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
 
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Chronic GVHD may improve the outcomes of cord blood transplantation for patients for MDS patients

演題番号 : OS-1-107

石山 謙 (Ken Ishiyama):1,2、青木 淳 (Jun Aoki):2、青木 一成 (Kazunari Aoki)、糸永 英弘 (Hidehiro Itonaga):4,5、石川 隆之 (Takayuki Ishikawa):3、宮崎 泰司 (Yasushi Miyazaki):5、谷口 修一 (Shuichi Taniguchi):6、大橋 一輝 (Kazuteru Ohashi):2、福田 隆浩 (Takahiro Fukuda):7、森 毅彦 (Takehiko Mori):8、森 慎一郎 (Shinichiro Mori):9、長村 登紀子 (Tokiko Nagamura):10、熱田 由子 (Yoshiko Atsuta):11、坂巻 壽 (Hisashi Sakamaki):2

1:Div. Hematology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan、2:Div. Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan、3:Dept. Hematology, Kobe City Medical Center General Hospital, Hyogo, Japan、4:Div. Hematology, Sasebo City General Hospital, Nagasaki, Japan、5:Dept. Hematology, Nagasaki University Hospital, Nagasaki, Japan、6:Dept. Hematology, Toranomon Hospital, Tokyo, Japan、7:Div. Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan、8:Div. Hematology, Keio University, Tokyo, Japan、9:Dept. Hemato-Oncology, St. Luke's International Hospital, Tokyo, Japan、10:Dept. Cell Processing and Transfusion, Institute of Medical Science, University of Tokyo, Tokyo, Japan、11:Dept. Hematopoietic Stem Cell Transplantation Data Management/Biostatistics, Nagoya University, Aichi, Japan

 

For myelodysplastic syndrome (MDS) patients, allogeneic stem cell transplant is the sole curative therapy. However, there has been concern that the rate of graft failure and the rate of relapse of the patients who receive cord blood transplant (CBT) is higher than that of patients who undergo bone marrow transplant from unrelated donors (URBMT). We conducted a retrospective study of the CBT outcomes of MDS patients using the Japan Society for Hematopoietic Cell Transplantation Data Registry database. MDS patients aged 16 years or older who underwent their first CBT between 1998 and 2010 were compared to those who underwent the first URBMT. We next examined the clinical factors affecting the overall survival (OS). There were 431 and 1093 MDS patients who received CBT and URBMT. The estimated 5-year OS of the CBT was significantly inferior to that of the URBMT (32% vs. 46%, p<0.0001). No significant differences were observed between the CBT and the URBMT in the 3-year cumulative incidence (CI) of non-relapse mortality (34% vs. 36%); however, the 3-year CI of relapse was significantly worse in the CBT than the URBMT (20% vs. 10% (p<0.0001)). The CI of neutrophil engraftment was 77% on day 100 after CBT. A proportional hazards model showed the recipients' age, diagnosis, performance status, fewer RBC transfusions and chronic GVHD (cGVHD) to all be variables affecting the OS. Our results suggest that the development of cGVHD might improve the OS in CBT. However, it is also necessary to carefully select the CBT candidates, because the OS of CBT may be inferior to that of URBMT.

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