Clinical significance of hemophagocytosis in BM clot sections during the peri-engraftment period following allogeneic hematopoietic SCT

N. Imahashi, Y. Inamoto, M. Ito, D. Koyama, T. Goto, K. Onodera, A. Seto, K. Watanabe, M. Imahashi, S. Nishiwaki, S. Tsukamoto, T. Yasuda, Y. Ozawa, K. Miyamura

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

The effects of macrophage activation on the outcome of allogeneic hematopoietic SCT (allo-HSCT) have yet to be fully examined. A total of 70 adult patients who received a first allo-HSCT for hematological diseases were studied. We counted the number of hemophagocytic cells in BM clot sections on day +14±7, and analyzed its impact on subsequent outcome. In all, 23 patients were diagnosed as having increased numbers of hemophagocytic cells (HP group), whereas 47 were not (non-HP group). The HP group was not associated with an increased incidence of acute or chronic GVHD, but was associated with worse hematopoietic recovery than the non-HP group. The 2-year OS for the HP group and the non-HP group was 30 and 65% (P<0.01), respectively, and 2-year non-relapse mortality was 48% and 27% (P<0.01), respectively. Multivariate analysis confirmed that the HP group was associated with a lower OS (hazard ratio (HR)=2.3; 95% confidence interval (CI), 1.0-5.4; P=0.048) and higher non-relapse mortality (HR=4.0; 95% CI, 1.6-9.9; P<0.01). The HP group had higher incidences of death due to graft failure (P<0.01) and endothelial complications, such as sinusoidal obstruction syndrome and transplant-associated microangiopathy (P=0.01). Macrophage activation is a previously unrecognized complication with negative impact on outcome of allo-HSCT.

Original languageEnglish
Pages (from-to)387-394
Number of pages8
JournalBone Marrow Transplantation
Volume47
Issue number3
DOIs
Publication statusPublished - 2012 Mar

Keywords

  • SCT
  • hemophagocytosis
  • macrophages
  • non-relapse mortality

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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