Blood and Marrow Transplantation Program, Division of Hematology and Medical Oncology, Hôpital Maisonneuve-Rosemont, Université de Montréal, 5415 Boulevard de l’Assomption, Montreal, Quebec, Canada.
Biol Blood Marrow Transplant. 2011 Nov;17(11):1673-8. doi: 10.1016/j.bbmt.2011.04.012. Epub 2011 May 3.
Data from a number of cohorts indicate that eosinophilia (Eo) could be associated with better outcomes following allogeneic hematopoietic cell transplant (HCT). However, little is known about its significance and prognostic value in chronic graft-versus-host disease (cGVHD) after nonmyeloablative (NMA) transplantation. Data were collected from 170 patients who underwent HCT using the same preparative regimen and GVHD prophylaxis. Donors were 6/6 HLA-matched siblings and stem cell source was peripheral blood. An eosinophil count of ≥0.5 × 10(9)/L was defined as Eo. Patients were transplanted mainly for lymphoproliferative disorders. Median age and follow-up were 54 years and 58 months, respectively. Incidents of grade II-IV acute GVHD (aGVHD) and cGVHD were 8.2% and 81.2%. Median time from HCT to cGVHD diagnosis was 142 days. Organs involved were: mouth in 80% of patients, skin in 75%, liver in 57%, eyes in 37%, gut in 14%, lungs in 5%, others in 5%. Eo was found in 44% of patients at diagnosis of cGVHD (range: 0.5-4.4 × 10(9)/L). Median time between first appearance of Eo and diagnosis of cGVHD was 4.5 days. We found no correlation between organ involvement and Eo but a lower prevalence of Eo in cGVHD associated with thrombocytopenia (P = .023). Nevertheless, we observed no association among Eo and overall survival (OS), relapse incidence, or nonrelapse mortality (NRM) in the overall cohort, nor in subsets of patients with multiple myeloma and follicular non-Hodgkin lymphoma. Although Eo is observed frequently in cGVHD following NMA transplantation, we report no correlation beween Eo and outcome.
一些队列研究的数据表明，嗜酸性粒细胞增多症（Eo）可能与异基因造血细胞移植（HCT）后更好的结局相关。然而，对于非清髓性（NMA）移植后慢性移植物抗宿主病（cGVHD），其意义和预后价值知之甚少。本研究数据来自 170 例接受相同预处理方案和移植物抗宿主病预防治疗的 HCT 患者。供者均为 6/6 HLA 匹配的同胞，干细胞来源为外周血。嗜酸性粒细胞计数≥0.5×10(9)/L 定义为 Eo。患者主要因淋巴细胞增生性疾病接受移植。中位年龄和随访时间分别为 54 岁和 58 个月。Ⅱ-Ⅳ级急性移植物抗宿主病（aGVHD）和 cGVHD 的发生率分别为 8.2%和 81.2%。从 HCT 到 cGVHD 诊断的中位时间为 142 天。受累器官包括：口腔 80%，皮肤 75%，肝脏 57%，眼睛 37%，胃肠道 14%，肺部 5%，其他 5%。cGVHD 诊断时发现 44%的患者存在 Eo（范围：0.5-4.4×10(9)/L）。首次出现 Eo 与 cGVHD 诊断之间的中位时间为 4.5 天。我们没有发现器官受累与 Eo 之间存在相关性，但与血小板减少症相关的 cGVHD 中 Eo 的发生率较低（P =.023）。然而，我们在整个队列中，以及多发性骨髓瘤和滤泡性非霍奇金淋巴瘤亚组患者中，均未观察到 Eo 与总生存（OS）、复发发生率或非复发死亡率（NRM）之间存在关联。尽管在 NMA 移植后 cGVHD 中经常观察到 Eo，但我们报告 Eo 与结局之间没有相关性。
