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

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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.

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Authors and Affiliations

  1. Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    Keiji Kurata & Hironobu Minami

  2. Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Keiji Kurata, Kimikazu Yakushi**, 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 & Hironobu Minami

  3. Department of Hematology, Hyogo Cancer Center, Akashi, Japan

    Ishikazu Mizuno, Hiroshi Gomyo & Tohru Murayama

  4. Department of Hematology/Oncology, Kakogawa Central City Hospital, Kakogawa, Japan

    Atsuo Okamura & Yumiko Inui

  5. Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Kobe, Japan

    Shinichiro Kawamoto

  6. Department of Hematology and Oncology, Kita-Harima Medical Center, Ono, Japan

    Takeshi Sugimoto

  7. Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan

    Mitsuhiro Ito

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  1. Keiji Kurata
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  2. Kimikazu Yakushi**
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  3. Ishikazu Mizuno
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Correspondence to Keiji Kurata.

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Kurata, K., Yakushi**, K., Mizuno, I. et al. Early lymphocyte recovery predicts clinical outcome after HSCT with mycophenolate mofetil prophylaxis in the Japanese population. Int J Hematol 108, 58–65 (2018). https://doi.org/10.1007/s12185-018-2437-z

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  • DOI: https://doi.org/10.1007/s12185-018-2437-z

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