演題詳細

一般口演 / Oral Session

一般口演 5 (Oral Session 5) :移植後合併症

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日程
2013年10月11日(金)
時間
09:30 - 10:30
会場
第5会場 / Room No.5 (さっぽろ芸文館 3F 清流)
座長・司会
谷口 修一 (Shuichi Taniguchi):1
1:虎の門病院 血液内科
 
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Risk factors for hemophagocytic syndrome following allogeneic hematopoietic cell transplantation

演題番号 : OS-1-24

南野 智 (Satoru Nanno):1、康 秀男 (Hideo Koh):1、坂部 真奈美 (Manami Sakabe):1、長崎 譲慈 (Joji Nagasaki):1、岡村 浩史 (Hiroshi Okamura):1、康 史朗 (Shiro Koh):1、吉村 卓朗 (Takuro Yoshimura):1、稲葉 晃子 (Akiko Inaba):1、相本 瑞樹 (Mizuki Aimoto):1、西本 光孝 (Mitsutaka Nishimoto):1、廣瀬 朝生 (Asao Hirose):1、中前 美佳 (Mika Nakamae):1、中嶋 康博 (Yasuhiro Nakashima):1、萩原 潔通 (Kiyoyuki Hagihara):1、中尾 吉孝 (Yoshitaka Nakao):1、中根 孝彦 (Takahiko Nakane):1、寺田 芳樹 (Yoshiki Terada):1、中前 博久 (Hirohisa Nakamae):1、日野 雅之 (Masayuki Hino):1

1:Hematology, Graduate School of Medicine, Osaka City University, Japan

 

Background&Methods: Some recent case series or retrospective studies suggest the entity of hemophagocytic syndrome (HPS) following allogeneic hematopoietic cell transplantation (allo-HCT), which might lead to graft rejection. However, the etiology of post-allo-HCT HPS remains unclear. To evaluate the risk factors for post-allo-HCT HPS, we retrospectively examined consecutive patients who underwent HCT at our institute between 2006 and 2012. HPS was diagnosed by modified HLH-2004 criteria. A total of 225 pts aged 16-69 (median 45) years were evaluable. Diseases were predominantly leukemia and MDS. A total of 187 pts received myeloablative conditioning. Donor sources were HLA-matched related peripheral blood (rPB) / bone marrow (BM) (n=38 / 9), haploidentical rPB (n=25), unrelated BM (n=100) and cord blood (n=53), and 135 had 6/6 HLA-A, B and DR antigen matching.
Results: A total of 18 pts developed HPS. Nine pts had pre-engraftment HPS, and engraftment failed in three. Fourteen pts had some infections at onset. In univariable logistic models, the following factors were statistically significant: HLA mismatch in both directions: GVH (Odds ratio 3.6; p=0.01) and HVG (4.0; p=0.006), use of antithymocyte globulin (2.8; p=0.044), and haploidentical rPB (3.8; p=0.046) and cord blood (3.0; p=0.047) (vs others), respectively. Acute GVHD was not significant. In multivariable models, HLA mismatch in both directions was similarly significant.
Conclusion: Our results suggest that allo-reactivity derived from HLA-mismatch may be associated with the development of post-allo-HCT HPS.

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