12th Congress of the European Hematology ... - Haematologica

admitted to ICU were discharged despite previous SCT. These patients
did not have a worse prognosis than those transferred to the ICU with
a hematologic malignancy, although the prognostic factors for survival
were different in the two groups of patients
Table 1.
Overall actuarial probability of survival
Overall (IC 95%) No SCT SCT
6 months 32%(23-41) 35%(25-45) 26%(10-42)
12 months 26%(17-35) 27%(17-37) 26%(10-42)
20 months 23%(15-31) 25%(15-35) 17%(0-34)
48 months 22%(14-30) 23%(13-33) 17%(0-34)
Actuarial probability of survival for discharged patients
Overall (IC 95%) No SCT SCT
6 months 74%(61-87) 73%(59-94) 72%(37-100)
12 months 60%(45-75) 56%(39-73) 72%(37-100)
20 months 53%(37-69) 53%(36-70) 48%(3-93)
48 months 50%(34-66) 49%(30-66) 48%(3-93)
Supported by: P-EF-06 from Jose Carreras International Leukemia Foundation
1200
SEQUENTIAL STUDY OF CYTOKINE AND LYMPHOCYTE PATTERNS IN PATIENTS WITH
CHRONIC GRAFT-VERSUS-HOST DISEASE AFTER REDUCED INTENSITY CONDITIONING
ALLOGENEIC STEM CELL TRANSPLANTATION
C.S. Skert, 1 D.D. Damiani, 2 M.A. Michelutti, 2 P.F. Patriarca, 2 F.C. Filì, 1
M.M. Malagola, 1 B.C. Bergonzi, 1 R.A. Roccaro, 1 R.D. Ricotta, 3
C.L. Caimi, 3 F.R. Fanin, 2 R.D. Russo1 1 USD TMO Adulti Brescia, BRESCIA; 2 Stem Cell Transplantation Unit,
UDINE, Italy; 3 Chair of Clinical Biochemistry, BRESCIA, Italy
Background. Chronic GVHD (cGVHD) is becoming a more and more
frequent complication of allogeneic stem cell transplantation (SCT),
because of increasing use of matched unrelated donors (MUD), peripheral
blood stem cells (PBSC) and reduced intensity conditioning (RIC)
regimens. Defects of both thymic function and peripheral immune regulation
seem to play a key role in its pathogenesis by inducing hyperactivation
of immune-system with cytokine dysregulation. Aims. We
tried to identify a possible correlation between patterns of cytokines and
of lymphocytes and cGVHD. Methods. We prospectively evaluated
cytokine levels and lymphocyte subsets in the late period after transplantation
( from 3rd month) in 12 patients who underwent RIC-SCT.
Results. Nine patients developed cGVHD at a median time of 6 months
(range, 6-10) from transplant. Before the onset of cGVHD, the patients
had an overall imbalance toward a Th1-TNF-α-response, as shown by:
higher levels of TNF-α from 3rd to 6th month, higher TNF-α/sTNF-RI
ratio at 3rd, 5th and 6th month, higher TNF-α/sTNF-RII ratio at 3rd and
5th month, higher TNF-α/IL-4 ratio at 3rd and 4th month, higher TNFα/IL-6
ratio at 5th and 6th month, higher TNF-α/IFN-gamma ratio from
3rd to 6th month. Th-2 cytokines were higher only at 4th month.
Patients with cGVHD showed lower levels of circulating NK cells and
lower CD3 + CD152 + /CD3 + CD28 + ratio at 3rd month. Conclusion. We
observed increased levels of both Th1 and Th2 cytokines with different
kinetics after RIC-SCT but with an overall prevalence of a TNF-α
oriented response before the onset of cGVHD. Defects of immunoregulatory
cells could be related to these fluctuating and unbalanced
cytokine patterns. Defining such patterns could be an important tool for
cGVHD modulation and for targeted therapies. However, further studies
with more patients are required to support these preliminary results.
1201
PHARMACOLOGICAL CURRENT TREATMENT OF CHRONIC MYELOID LEUKAEMIA IN
SPAIN. TRANSVERSAL AND OBSERVATIONAL STUDY IN 330 PATIENTS OF THE SPANISH
REGISTRY OF CHRONIC MYELOID LEUKEMIA (RELMC)
L.F. Casado Montero, 1 P. Giraldo, 2 I. Massagué, 3 R. De Paz, 4 C. Calle, 5
R. Forés, 6 Q. Albizua, 7 C. Burgaleta, 8 J.L. Steegmann9 1 Hospital Virgen de la salud, TOLEDO; 2 Hospital Miguel Servet,
ZARAGOZA; 3 Hospital Vall d´Hebron, BARCELONA; 4 Hospital de la Paz,
MADRID; 5 Hospital General de Ciudad Real, CIUDAD REAL, Spain; 6 Hospital
Puerta de Hierro, MADRID; 7 Hospital Doce de Octubre, MADRID; 8 Hospital
Principes de Asturias, ALCALÁ DE HENARES; 9 Hospital Universitario
de la Princesa, MADRID, Spain
Introduction. Little is known about the actual situation of the current
pharmacological treatment of Chronic Myeloid Leukaemia (CML) in
Spain since the introduction of imatinib and other TK inhibitors and its
repercussion in the change of treatment and outcome of these patients
in our country. Methods. Inclusion criteria: CML patients treated only
with drugs. The study collected patients treated at any time with Imatinib,
and patients treated after 31 st Dec 2002, with any drug.The information
has been introduced by in situ monitoring by a data manager and
was web based. The study is observational and population based, and
comprises of complete information in pharmacological treatment of the
first 330 patients with CML of diferent hospitals around different Spanish
regions. Results. 330 patients, 61% men, 39% women. All of them
were in the first chronic phase in the moment the study started(Sokal
Index risk group low 55%, intermediate 31% high 14%) (Hasford risk
group low 54%, intermediate 42% high 4% . The median of age was
53 years (ratio 20-91 years). 24% of the patients had received IFN as first
line treatment. In the moment of analysis, 71% of the patients received
Imatinib 400 mg, 1% imatinib 500, 12% imatinib 600 mg, 6% imatinib
800 mg, 1% dasatinib 100, 1% dasatinib 140 and 8% different combinations
of interferon α and hydroxiurea. The Table 1 summarizes the
best response of those patients treated with Imatinib, at any dose. Conclusion.
This study is the first population based study which describes
the pharmacological treatment of CML in Spain, outside clinical trials.
We show the great importance of imatinib as current treatment in the
CML.The results are fairly similar to those reported in clinical trials,
and it would be a useful base for new longitudinal studies.
Table 1.
12 th Congress of the European Hematology Association
haematologica/the hematology journal | 2007; 92(s1) | 439