ダウンロード数: 116
このアイテムのファイル:
ファイル | 記述 | サイズ | フォーマット | |
---|---|---|---|---|
bloodadvances.2020002007.pdf | 1.1 MB | Adobe PDF | 見る/開く |
タイトル: | Risk factors and appropriate therapeutic strategies for thrombotic microangiopathy after allogeneic HSCT |
著者: | Matsui, Hiroyuki Arai, Yasuyuki https://orcid.org/0000-0002-9662-5093 (unconfirmed) Imoto, Hiroharu Mitsuyoshi, Takaya Tamura, Naoki Kondo, Tadakazu Kanda, Junya https://orcid.org/0000-0002-6704-3633 (unconfirmed) Ishikawa, Takayuki Imada, Kazunori Ueda, Yasunori Toda, Yusuke Anzai, Naoyuki Yago, Kazuhiro Nohgawa, Masaharu Yonezawa, Akihito Tsunemine, Hiroko Itoh, Mitsuru Yamamoto, Kazuyo Tsuji, Masaaki Moriguchi, Toshinori Takaori-Kondo, Akifumi Kyoto Stem Cell Transplantation Group (KSCTG) |
著者名の別形: | 松井, 宏行 新井, 康之 光吉, 貴哉 田村, 直紀 近藤, 忠一 諫田, 淳也 今田, 和典 上田, 恭典 戸田, 有亮 安齋, 尚之 野吾, 和宏 直川, 匡晴 米澤, 昭仁 常峰, 紘子 伊藤, 満 山本, 和代 辻, 將公 森口, 寿徳 髙折, 晃史 |
キーワード: | Platelets and Thrombopoiesis Transplantation |
発行日: | 14-Jul-2020 |
出版者: | American Society of Hematology |
誌名: | Blood Advances |
巻: | 4 |
号: | 13 |
開始ページ: | 3169 |
終了ページ: | 3179 |
抄録: | Transplant-associated thrombotic microangiopathy (TA-TMA) is a fatal complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, so far, no large cohort study determined the risk factors and the most effective therapeutic strategies for TA-TMA. Thus, the present study aimed to clarify these clinical aspects based on a large multicenter cohort. This retrospective cohort study was performed by the Kyoto Stem Cell Transplantation Group (KSCTG). A total of 2425 patients were enrolled from 14 institutions. All patients were aged ≥16 years, presented with hematological diseases, and received allo-HSCT after the year 2000. TA-TMA was observed in 121 patients (5.0%) on day 35 (median) and was clearly correlated with inferior overall survival (OS) (hazard ratio [HR], 4.93). Pre- and post-HSCT statistically significant risk factors identified by multivariate analyses included poorer performance status (HR, 1.69), HLA mismatch (HR, 2.17), acute graft-versus-host disease (aGVHD; grades 3-4) (HR, 4.02), Aspergillus infection (HR, 2.29), and veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS; HR, 4.47). The response rate and OS significantly better with the continuation or careful reduction of calcineurin inhibitors (CNI) than the conventional treatment strategy of switching from CNI to corticosteroids (response rate, 64.7% vs 20.0%). In summary, we identified the risk factors and the most appropriate therapeutic strategies for TA-TMA. The described treatment strategy could improve the outcomes of patients with TA-TMA in the future. |
記述: | 移植後血栓性微小血管障害の発症リスク因子を発見 --KSCTGコホート研究に基づく新たな最適治療戦略--. 京都大学プレスリリース. 2020-07-14. |
著作権等: | © 2020 by The American Society of Hematology 許諾条件に基づいて掲載しています。 |
URI: | http://hdl.handle.net/2433/253080 |
DOI(出版社版): | 10.1182/bloodadvances.2020002007 |
PubMed ID: | 32658984 |
関連リンク: | https://www.kyoto-u.ac.jp/ja/research-news/2020-07-14 |
出現コレクション: | 学術雑誌掲載論文等 |
このリポジトリに保管されているアイテムはすべて著作権により保護されています。