Takenaka Katsuto, Shimoda Kazuya, Uchida Naoyuki, Shimomura Taizo, Nagafuji Koji, Kondo Tadakazu, Shibayama Hirohiko, Mori Takehiko, Usuki Kensuke, Azuma Taichi, Tsutsumi Yutaka, Tanaka Junji, Dairaku Hitomi, Matsuo Keitaro, Ozawa Keiya, Kurokawa Mineo, Arai Shunya, Akashi Koichi
Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Int J Hematol. 2017 Jan;105(1):59-69. doi: 10.1007/s12185-016-2102-3. Epub 2016 Oct 19.
We conducted a 17-year nationwide survey (1999-2015) to elucidate the clinical outcomes of patients with primary myelofibrosis (PMF) in Japan. Questionnaires were sent annually to approximately 500 hematology departments. Newly diagnosed patients with PMF were enrolled in this study, and were followed up annually to collect prognostic information. Approximately 50 patients were enrolled per year, yielding a total of 780 patients with PMF included in this study. The median age at diagnosis was 66 years. At the time of analysis, the median survival duration was 47 months, and the 3-year overall survival rate was 59 %. Infection and disease transformation into acute leukemia were the most frequent causes of death. Of the proposed prognostic models for predicting the outcomes of PMF patients in Japan, the Dynamic International Prognostic Scoring System of PMF plus model was the most feasible. Forty-three patients received allogeneic hematopoietic stem cell transplantation (alloSCT) at a median of 343 days after diagnosis. This treatment significantly prolonged the survival of PMF patients, and the 3-year overall survival rate after first alloSCT was 84 %. A long-term registration study is required for further evaluation of prognosis and the impact of treatments on survival.
我们开展了一项为期17年的全国性调查(1999 - 2015年),以阐明日本原发性骨髓纤维化(PMF)患者的临床结局。每年向约500个血液科发送调查问卷。新诊断的PMF患者纳入本研究,并每年进行随访以收集预后信息。每年约有50例患者入组,本研究共纳入780例PMF患者。诊断时的中位年龄为66岁。分析时,中位生存时间为47个月,3年总生存率为59%。感染和疾病转化为急性白血病是最常见的死亡原因。在日本用于预测PMF患者结局的预后模型中,PMF动态国际预后评分系统加模型是最可行的。43例患者在诊断后中位343天接受了异基因造血干细胞移植(alloSCT)。这种治疗显著延长了PMF患者的生存期,首次alloSCT后的3年总生存率为84%。需要进行长期登记研究以进一步评估预后以及治疗对生存的影响。