International Journal of Hematology

, Volume 108, Issue 1, pp 58–65 | Cite as

Early lymphocyte recovery predicts clinical outcome after HSCT with mycophenolate mofetil prophylaxis in the Japanese population

  • Keiji Kurata
  • Kimikazu Yakushijin
  • Ishikazu Mizuno
  • Hiroshi Gomyo
  • Atsuo Okamura
  • Hiroya Ichikawa
  • Rina Sakai
  • Yu Mizutani
  • Seiji Kakiuchi
  • Yoshiharu Miyata
  • Akihito Kitao
  • Yukinari Sanada
  • Yumiko Inui
  • Kiyoaki Uryu
  • Shinichiro Kawamoto
  • Takeshi Sugimoto
  • Katsuya Yamamoto
  • Mitsuhiro Ito
  • Hiroshi Matsuoka
  • Tohru Murayama
  • Hironobu Minami
Original Article
  • 46 Downloads

Abstract

Immune reconstitution affects clinical outcomes after allogeneic hematopoietic stem cell transplantation (HSCT), and it has been suggested that lymphocyte recovery affects survival after HSCT. However, few studies have examined lymphocyte recovery in Asian patients who received mycophenolate mofetil (MMF) prophylaxis for graft-versus-host disease. We retrospectively evaluated early lymphocyte recovery after HSCT among Japanese adults who received MMF prophylaxis. Patients were divided into two groups according to their median absolute lymphocyte count (ALC) on day 28 after HSCT as follows: the “low ALC group” (≤ 0.22 × 109 cells/L) and the “high ALC group” (> 0.22 × 109 cells/L). With a median follow-up of 317 days, the high ALC group showed significantly better overall survival than the low ALC group (at 1 year: 62 vs. 46%, P = 0.02). The high ALC group also tended to have better non-relapse mortality than the low ALC group (at 1 year: 13 vs. 23%, P = 0.08). There was no significant difference in relapse rate between the high and low ALC groups (at 1 year: 29 vs. 35%, P = 0.2). We conclude that among Japanese patients who received MMF prophylaxis, ALC on day 28 after HSCT was effective in predicting overall survival and non-relapse mortality.

Keywords

Absolute lymphocyte recovery Hematopoietic stem cell transplantation Mycophenolate mofetil 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Keiji Kurata
    • 1
    • 2
  • Kimikazu Yakushijin
    • 2
  • Ishikazu Mizuno
    • 3
  • Hiroshi Gomyo
    • 3
  • Atsuo Okamura
    • 2
    • 4
  • Hiroya Ichikawa
    • 2
  • Rina Sakai
    • 2
  • Yu Mizutani
    • 2
  • Seiji Kakiuchi
    • 2
  • Yoshiharu Miyata
    • 2
  • Akihito Kitao
    • 2
  • Yukinari Sanada
    • 2
  • Yumiko Inui
    • 2
    • 4
  • Kiyoaki Uryu
    • 2
  • Shinichiro Kawamoto
    • 2
    • 5
  • Takeshi Sugimoto
    • 2
    • 6
  • Katsuya Yamamoto
    • 2
  • Mitsuhiro Ito
    • 2
    • 7
  • Hiroshi Matsuoka
    • 2
  • Tohru Murayama
    • 3
  • Hironobu Minami
    • 1
    • 2
  1. 1.Division of Medical Oncology/Hematology, Department of MedicineKobe University Graduate School of MedicineKobeJapan
  2. 2.Department of Medical Oncology and HematologyKobe University HospitalKobeJapan
  3. 3.Department of HematologyHyogo Cancer CenterAkashiJapan
  4. 4.Department of Hematology/OncologyKakogawa Central City HospitalKakogawaJapan
  5. 5.Department of Transfusion Medicine and Cell TherapyKobe University HospitalKobeJapan
  6. 6.Department of Hematology and OncologyKita-Harima Medical CenterOnoJapan
  7. 7.Laboratory of Hematology, Division of Medical BiophysicsKobe University Graduate School of Health SciencesKobeJapan

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