Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Transplant Cell Ther. 2021 Apr;27(4):336.e1-336.e9. doi: 10.1016/j.jtct.2021.01.027. Epub 2021 Feb 4.
Peripheral blood eosinophilia has been associated with the development of graft-versus-host disease (GVHD) and survival after allogeneic hematopoietic cell transplantation (HCT). However, the impacts of eosinophilia on cord blood transplantation (CBT) outcomes remain unclear. The objective of this study was to examine the associations between eosinophilia and overall survival, relapse incidence, non-relapse mortality, and acute and chronic GVHD after single-unit CBT for adults. We retrospectively analyzed the data for 225 adult patients who received single-unit CBT at our institute between March 2004 and March 2020. The cumulative incidence of eosinophilia, defined as an absolute eosinophil count of ≥500 × 10/L in peripheral blood, was 48.9% (95% confidence interval, 42.2% to 55.2%) at 60 days after CBT. Recipient cytomegalovirus seronegative status and higher cryopreserved cord blood CD34 cell dose were significantly associated with a higher incidence of eosinophilia after CBT. Among patients who achieved neutrophil recovery, neutrophil recovery was significantly earlier in patient with eosinophilia compared to those without eosinophilia (P = .016). Serum levels of interleukin-5 at 4 weeks were significantly higher in patients with eosinophilia compared with those without eosinophilia (P = .041). Multivariate analysis, in which the development of eosinophilia was treated as a time-dependent covariate, showed that eosinophilia was significantly associated with lower overall mortality (hazard ratio [HR], .58; P = .034) and non-relapse mortality (HR, .41; P = .029), but not relapse incidence or development of acute or chronic GVHD. Our data suggested that early-phase eosinophilia is a predictor of favorable outcomes in adult patients undergoing single-unit CBT.
外周血嗜酸性粒细胞增多与移植物抗宿主病 (GVHD) 的发展和异基因造血细胞移植 (HCT) 后的生存有关。然而，嗜酸性粒细胞增多对脐血移植 (CBT) 结果的影响尚不清楚。本研究旨在探讨单份脐血移植后成人嗜酸性粒细胞增多与总生存、复发率、非复发死亡率以及急性和慢性 GVHD 的关系。我们回顾性分析了 2004 年 3 月至 2020 年 3 月期间在我院接受单份 CBT 的 225 例成人患者的数据。CBT 后 60 天，外周血嗜酸性粒细胞绝对计数≥500×10/L 的嗜酸性粒细胞增多累积发生率为 48.9%（95%置信区间，42.2%至 55.2%）。受者巨细胞病毒阴性状态和更高的冷冻保存脐血 CD34 细胞剂量与 CBT 后嗜酸性粒细胞增多的发生率显著相关。在中性粒细胞恢复的患者中，与无嗜酸性粒细胞增多的患者相比，嗜酸性粒细胞增多的患者中性粒细胞恢复更早（P=0.016）。与无嗜酸性粒细胞增多的患者相比，嗜酸性粒细胞增多的患者在第 4 周时血清白细胞介素-5 水平显著升高（P=0.041）。多变量分析中，将嗜酸性粒细胞增多作为时间依赖性协变量进行处理，结果显示嗜酸性粒细胞增多与总死亡率降低显著相关（风险比 [HR]，0.58；P=0.034）和非复发死亡率降低显著相关（HR，0.41；P=0.029），但与复发率或急性或慢性 GVHD 的发生无关。我们的数据表明，早期嗜酸性粒细胞增多是单份脐血移植成人患者预后良好的预测指标。
