演題詳細

一般口演 / Oral Session

一般口演 108 (Oral Session 108) :感染症・その他

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日程
2013年10月13日(日)
時間
16:00 - 17:00
会場
第14会場 / Room No.14 (札幌市教育文化会館 3F 研修室305)
座長・司会
岩崎 博道 (Hiromichi Iwasaki):1
1:福井大学医学部 感染制御部
 
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Retrospective analysis of hypogammaglobulinemia after allogeneic stem cell transplantation

演題番号 : OS-3-187

新井 康之 (Yasuyuki Arai):1、山下 浩平 (Kouhei Yamashita):1、近藤 忠一 (Tadakazu Kondo):1、北野 俊行 (Toshiyuki Kitano):1、高折 晃史 (Akifumi Takaori-Kondo):1

1:Department of Hematology and Oncology, Kyoto University, Japan

 

Introduction:Although hypogammaglobulinemia (hypo-IgG) is one of the important complications after allo-SCT, associated risk factors for hypo-IgG and its effects on prognosis remain unknown.
Patients and Methods:We retrospectively analyzed 211 patients who underwent allo-SCT over 7 years. Serum IgG was measured from pre-conditioning to 3 years after SCT or upon relapse. Hypo-IgG was defined as IgG < 400 mg/dL.
Results:IgG values were significantly lower 2 weeks after SCT than those at pre-conditioning (median, 963.1 vs 810.5 mg/dL, p < 0.01). The IgG values were the lowest at 6 months (757.7 mg/dL), and recovered to the pre-conditioning level around 1 year after SCT (958.9 mg/dL). Hypo-IgG was observed in 49 patients 5-1865 (median, 77) days after SCT; the cumulative incidence was 27.9% at 1 year. IVIg was administered for 85 patients. The significant risk factors for hypo-IgG were lymphoid malignancies (hazard ratio [HR], 3.28), second SCT (HR, 1.94), use of MMF as aGVHD prophylaxis (HR, 2.55), severe aGVHD (HR, 2.09), and cGVHD (HR, 1.87). Hypo-IgG was associated with poor prognosis; lower 3-year OS (53.1% vs 63.2%, p = 0.18) and higher TRM (28.3% vs 11.0%, p = 0.02), which were attributed to infection; CMV or HHV-6 reactivation and hemorrhagic cystitis significantly increased in the hypo-IgG group especially after CBT.
Conclusions:We found that use of MMF is a risk factor for hypo-IgG, in addition to other conventional factors. Periodical IgG measurements and, if necessary, IVIg administration are recommended to reduce infections and TRM for patients with these risk factors.

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