Increased opportunity for prolonged survival after allogeneic hematopoietic stem cell transplantation in patients aged 60–69 years with myelodysplastic syndrome View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03-11

AUTHORS

Hidehiro Itonaga, Ken Ishiyama, Kazunari Aoki, Jun Aoki, Takayuki Ishikawa, Naoyuki Uchida, Kazuteru Ohashi, Yasunori Ueda, Takahiro Fukuda, Toru Sakura, Yuju Ohno, Koji Iwato, Hirokazu Okumura, Tadakazu Kondo, Tatsuo Ichinohe, Minoko Takanashi, Yoshiko Atsuta, Yasushi Miyazaki

ABSTRACT

We conducted a nationwide retrospective study to evaluate the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 651 patients aged 60–69 years with de novo myelodysplastic syndrome (MDS). We divided patients into two groups: 152 and 499 patients with an early and advanced disease status, respectively. The 3-year overall survival (OS) rate of patients with an early disease status was 45.9% (95% confidence interval [CI], 37.0 to 54.2%). A multivariate analysis revealed five adverse factors for OS: performance status (PS) 2–4 (hazard ratio [HR] 4.48; P < .001), poor cytogenetic risk group (HR 1.83; P = .041), male recipient (HR 2.58; P = .003), use of HLA-mismatched related grafts (HR 4.75; P = .003), and unrelated cord blood (HR 2.47; P = .023). The 3-year OS rate of patients with an advanced disease status was 37.2% (95% CI 32.4 to 41.9%). Five factors correlated with worse OS: PS 2–4 (HR 1.72; P = .003), poor cytogenetic risk group (HR 1.49; P = .003), use of HLA-mismatched related grafts (HR 1.96; P = .015), unrelated cord blood (HR 2.05; P < .001), and the high number of red blood cell transfusions before transplantation (HR 1.85; P = .018). The present results revealed the more frequent utilization of allo-HSCT for MDS patients aged 60–69 years, which increases the curative potential. More... »

PAGES

1367-1381

References to SciGraph publications

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  • Journal

    TITLE

    Annals of Hematology

    ISSUE

    6

    VOLUME

    98

    Author Affiliations

  • Department of Hematology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan
  • Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan
  • Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  • Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
  • Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
  • Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
  • Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
  • Department of Hematology/Oncology and Transfusion and Hemapheresis Center, Kurashiki Central Hospital, Kurashiki, Japan
  • Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
  • Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Gunma, Japan
  • Department of Internal Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
  • Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
  • Department of Internal Medicine (Hematology), Toyama Prefectural Central Hospital, Toyama, Japan
  • Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
  • Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00277-019-03653-7

    DOI

    http://dx.doi.org/10.1007/s00277-019-03653-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1112678641

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30854574


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