Eosinophilia, Regardless of Degree, is Related to Better Outcomes after Allogeneic Hematopoietic Stem Cell Transplantation

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概要

• 論文の詳細を見る

• Objective Several recent studies report that, after allogeneic hematopoietic cell transplantation (allo-HCT), eosinophilia is a favorable factor for transplant outcomes. However, whether the degree of eosinophilia influences transplant outcomes is yet to be established. Methods We studied 144 patients with hematological malignancy who received allo-HCT at our institution. The stem cell sources were bone marrow in 84 patients, peripheral blood stem cells in 32 patients, and cord blood in 28 patients. One hundred and twelve patients underwent myeloablative conditioning and 49 patients had high-risk disease. We performed semi-landmark analysis to examine the influence of eosinophilia. Results Eosinophilia developed at a median of 47 days after transplantation in 63 patients (44%). The patients with eosinophilia showed significantly better overall survival (OS) and a lower relapse rate at three years, compared to those without eosinophilia (66% vs 55%, p=0.04 and 30% vs 50%, p=0.002). On analysis following division into groups with mild (500-1,500×106/L) and hyper- (>1,500×106/L) eosinophilia, three-year OS and relapse rates were 68% and 65% (p=0.92), and 31% and 28% (p=0.90), respectively. On multivariate analysis, eosinophilia was significantly associated with lower relapse rates [HR: 0.5 (95% CI: 0.3-0.9), p=0.01] and the same trend was preserved in the analysis of the mild and hyper-eosinophilic groups. Conclusion The results suggest that eosinophilia after allo-HCT was associated with better OS and a lower relapse rate, regardless of the levels. The mechanism of this effect is still unclear, and requires study of the pathophysiological process to clarify the relationship between the higher levels of eosinophilia after allo-HCT and organ infiltration.

著者

• Hino Masayuki

  Hematology Graduate School Of Medicine Osaka City University

• Koh Hideo

  Hematology Graduate School Of Medicine Osaka City University

• Nakamae Mika

  Hematology Graduate School Of Medicine Osaka City University

• Terada Yoshiki

  Hematology Graduate School Of Medicine Osaka City University

• Nakane Takahiko

  Hematology Graduate School Of Medicine Osaka City University

• Nakamae Hirohisa

  Hematology Graduate School Of Medicine Osaka City University

• Nishimoto Mitsutaka

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Hayashi Yoshiki

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Yoshida Masahiro

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Bingo Masato

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Okamura Hiroshi

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Aimoto Mizuki

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Yoshimura Takuro

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Hirose Asao

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Nakao Yoshitaka

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Nakane Takahiko

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Hino Masayuki

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Umemoto Yukari

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Ichihara Hiroyoshi

  Hematology, Graduate School of Medicine, Osaka City University, Japan

• Ohsawa Masahiko

  Diagnostic Pathology, Graduate School of Medicine, Osaka City University, Japan

• Nakamae Hirohisa

  Hematology, Graduate School of Medicine, Osaka City University, Japan

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• Eosinophilia, Regardless of Degree, is Related to Better Outcomes after Allogeneic Hematopoietic Stem Cell Transplantation

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