Distinctive clinical characteristics and favorable outcomes in patients with large granular lymphocytosis after allo-HCT: 12-year follow-up data

Autor: Dennis Dong Hwan Kim, Hans A. Messner, Auro Viswabandya, Nada Hamad, Joon Ho Moon, Elizabeth Shin, Marc Poch Martell, Jeffrey H. Lipton, Sang Kyun Sohn, Fotios V. Michelis, Jieun Uhm
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Transplantation Conditioning
Lymphocytosis
Adolescent
Graft vs Host Disease
chemical and pharmacologic phenomena
Viremia
Lower risk
Gastroenterology
Immunophenotyping
03 medical and health sciences
Young Adult
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Transplantation
Homologous
Cumulative incidence
In patient
Large granular lymphocytosis
Aged
business.industry
Incidence
Hematopoietic Stem Cell Transplantation
Neoplasms
Second Primary
Hematology
General Medicine
Middle Aged
medicine.disease
Prognosis
Survival Analysis
Transplantation
Leukemia
Large Granular Lymphocytic
Graft-versus-host disease
030220 oncology & carcinogenesis
Immunology
Cytomegalovirus Infections
Female
medicine.symptom
Symptom Assessment
business
030215 immunology
Follow-Up Studies
Zdroj: European journal of haematology. 99(2)
ISSN: 1600-0609
Popis: An increase in large granular lymphocytes (LGL) is frequently seen in patients following allogeneic hematopoietic cell transplantation (allo-HCT) and it has been associated with better outcomes in some reports. We assessed 826 consecutive patients at our institution with over 12 years of follow-up for the occurrence of LGL lymphocytosis after allo-HCT. The 3 year cumulative incidence of LGL lymphocytosis was 14.5% with a median duration of over 3.5 years. The developmnet of LGL lymphocytosis was strongly correlated with CMV viremia and GVHD. The clinical course of patients with LGL lymphocytosis after allo-HCT was indolent, with the majority of these patients not displaying any clinical signs or symptoms related to the LGL proliferation. LGL lymphocytosis was associated with better outcomes, including higher overall survival (OS 86.6% vs 44.7% at 3 years), lower non-relapse mortality (NRM 5.5% vs 30.4% at 3 years) and lower risk of relapse (8.9% vs 22.9% at 3 years). A time-dependent multivariable analysis confirmed the favorable impact of LGL lymphocytosis on OS and NRM, but not on the risk of relapse. In multivariable analysis, a longer duration of LGL lymphocytosis was associated with better OS and NRM. Improved immunomodulatory properties of these cells, regulating GVHD and infections may explain the observed favourable outcomes of patients who developed LGL lymphocytosis following allo-HCT. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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