scholarly journals Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

2010 ◽  
Vol 46 (2) ◽  
pp. 208-216 ◽  
Author(s):  
J Kanda ◽  
C Mizumoto ◽  
T Ichinohe ◽  
H Kawabata ◽  
T Saito ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Cell Transplantation ◽  
Serum Ferritin ◽  
Predictive Factors ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
C Reactive Protein ◽  
Reactive Protein

Validation of Favourable Impact of Large Granular Lymphocytosis after Allogeneic Hematopoietic Cell Transplantation

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3936-3936
Author(s):  
Marc Poch Martell ◽  
Jieun Uhm ◽  
Naheed Alam ◽  
Vikas Gupta ◽  
Jeffrey H. Lipton ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Predictive Factors ◽  
Lymphocyte Count ◽  
Hematopoietic Cell Transplantation ◽  
Chronic Gvhd ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Gvhd Prophylaxis ◽  
Significant Difference ◽  
Persistent Elevation

Abstract Introduction: We previously reported on the incidence of large granular lymphocytosis (LGL) following allogeneic hematopoietic cell transplantation (allo-HCT), its favorable impact on outcome and the predictive factors associated with its development (D Kim, BMT, 2013). In the current study we aimed to validate our previous findings in an independent set of patients. Methods:All 408 patients undergoing allo-HCT at Princess Margaret Cancer Centre, Toronto, from 2007 to 2012 (replication set) were included retrospectively. Data from the previously reported set of patients undergoing allo-HCT from 2000 to 2007 (n = 418) (original set) were updated. Results:There were significant differences between original and replication sets in baseline characteristics (age, underlying disease, conditioning, GvHD prophylaxis, graft source, donor type, and incidences of GvHD and CMV viremia) in accordance to the changes over a decade in allo-HCT procedures. The cumulative incidence of LGL lymphocytosis at 3 years was 21.8% in the original set and 11.7% in the replication set (P<0.001). The median onset of LGL lymphocytosis was 362 days after HCT in the original set and 223 days in the replication set. Patients with LGL lymphocytosis showed a persistent elevation of lymphocyte count compared to patients without LGL lymphocytosis (P<0.001). Patients with LGL lymphocytosis showed a higher overall survival (OS) (86.4% vs 46.1%, P<0.001, Fig. A) and lower non-relapse mortality (NRM) (10.5% vs 36.3%, P<0.001, Fig. B) at 3 years. No significant difference was found in relapse incidence according to the development of LGL lymphocytosis (13.9% vs 19.6%, P=0.25). Multivariable analysis confirmed the favorable impact of LGL lymphocytosis on OS (HR 0.30, P=0.02) and a trend towards lower NRM (HR 0.27, P<0.001, original set; HR 0.50, P=0.22, replication set). No effect of LGL lymphocytosis on relapse incidence was demonstrated (HR 1.24, P=0.37, original set; HR 0.53, P=0.29, replication set). Patients with LGL lymphocytosis showed a trend towards a higher incidence of IST cessation after cGvHD: 63.6% at 7 years vs 53.4% in patients without LGL lymphocytosis, P=0.07. The previously identified predictive factors for the development of LGL lymphocytosis were replicated: higher incidence of LGL lymphocytosis with 1) CMV seropositive recipients (29.6% vs 5.1%, P < 0.001); 2) CMV viremia (31.0% vs 8.9%, P<0.001) and 3) chronic GvHD (28.2%, vs 5.0%, P<0.001). Conclusions: The favorable impact of LGL lymphocytosis following allo-HCT in OS and NRM, as well as the predictive factors for the development of LGL lymphocytosis were successfully validated in an independent cohort of patients. No impact of LGL lymphocytosis on relapse incidence was noted. The difference in transplantation procedures between the two cohorts, such as GvHD prophylaxis/T-cell depletion, may explain the lower incidence of LGL lymphocytosis in the replication cohort. Patients with LGL lymphocytosis showed a trend towards a higher incidence of IST cessation after cGvHD, which may explain the lower NRM. Patients with LGL lymphocytosis showed a persistent elevation of lymphocyte count and had an indolent course. OS and NRM according to the development of LGL lymphocytosis Disclosures No relevant conflicts of interest to declare.

Prognostic Value and Clinical Implication of Serum Ferritin Levels following Allogeneic Hematopoietic Cell Transplantation

2014 ◽  
Vol 133 (3) ◽  
pp. 310-316 ◽  
Author(s):  
Mika Nakamae ◽  
Hirohisa Nakamae ◽  
Shiro Koh ◽  
Hideo Koh ◽  
Mitsutaka Nishimoto ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Serum Ferritin ◽  
Hematopoietic Cell Transplantation ◽  
Ferritin Level ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Red Blood Cell Transfusion ◽  
Acute Phase Reactants ◽  
A Prospective Study ◽  
Worse Prognosis

Little research has been done on changes in serum ferritin (s-ferritin) levels and clinical implications following allogeneic hematopoietic cell transplantation (HCT). We retrospectively evaluated the correlation of s-ferritin levels after HCT with survival in 203 patients. The s-ferritin level was significantly elevated, with 75% of the patients showing peak levels 90 days after HCT. The level was >10,000 ng/ml in a total of 43% of the patients, a finding that was associated with febrile neutropenia or infection. The s-ferritin level at day 30 and at 1 year after HCT was significantly associated with prognosis. However, this statistically significant relationship was lost after adjusting for acute-phase reactants. We conclude that hyperferritinemia is very common and the degree of influence of a red blood cell transfusion will vary depending on the phase after HCT. A prospective study is needed to determine if iron load in and of itself contributes to a worse prognosis after HCT. © 2014 S. Karger AG, Basel

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