To investigate the long-term usefulness of immunosuppressive therapy (IST) for Japanese patients with lower-risk myelodysplastic syndromes, we retrospectively analyzed 29 MDS patients who were treated with cyclosporine A alone or with anti-thymocyte globulin at a single institute in Japan. A total of 58.6 % of patients showed hematological response to IST. Overall survival of all patients was 74.5 % at 5 years and 48.3 % at 10 years. The major adverse event was the elevation of creatinine level (grade 1 and 2). Eleven patients were still on IST at the time of analysis with, at least, some clinical benefits. Pneumonia was the most frequent cause of death (eight of 12 deaths), followed by bleeding (three of 12); most of the patients who died were non-responders. The presence of paroxysmal nocturnal hemoglobinuria-type cells was significantly associated with both response to IST and long-term survival by univariate analysis. The 10-year overall survival of responders (72.2 %) was significantly superior to that of non-responders (15.6 %, P < 0.0001). These results suggest that IST using cyclosporine A provides long-term benefit for Japanese patients with lower-risk MDS.
雑誌名
International Journal of Hematology
巻
98
号
6
ページ
687 - 693
発行年
2013-12
出版者
日本血液学会
出版者別言語
Japanese Society of Hematology
ISSN
09255710
EISSN
18653774
DOI
10.1007/s12185-013-1468-8
権利
c 2013 The Japanese Society of Hematology.
The original publication is available at www.springerlink.com
著者版フラグ
author
引用
International Journal of Hematology, 98(6), pp.687-693; 2013