Hyperacute GVHD and emergence of peripheral CD3+CD56+ T cells and activated natural killer cells are useful markers for early diagnosis of post-transplant hemophagocytic syndrome

Kishi, Yoshiki; Kami, Masahiro; Murashige, Naoko; Tanaka, Yukië; Haraguchi, Kazutoshi; Fujisaki, G.; Kusumoto, Shiro; Mori, Shin Ichiro; Takaue, Yoichi; Tanosaki, Ryuji

doi:10.1038/sj.bmt.1704771

Cited by 10 publications

(9 citation statements)

References 8 publications

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“…Our results demonstrated that HPS is an aggressive and devastating complication after CBT that closely correlates with delayed engraftment or failure, resulting in a poor OS. As far as we understand from the English medical literature (Table V), only 23 patients in 16 case reports appear to have developed HPS after autologous ( n = 5) and allogeneic ( n = 18) HSCT (Sokal et al , 1987; Levy et al , 1990; Reardon et al , 1991; Nagafuji et al , 1998; Sato et al , 1998; Takahashi et al , 1998; Ishikawa et al , 2000; Fukuno et al , 2001; Abe et al , 2002; Tanaka et al , 2004, 2007; Kishi et al , 2005a; Boelens et al , 2006; Ostronoff et al , 2006; Ishida et al , 2007; Koyama et al , 2007). Among 18 patients who received allogeneic HSCT, reduced‐intensity preparative regimens were employed in nine patients and three underwent CBT.…”

Section: Discussionmentioning

confidence: 99%

High incidence of haemophagocytic syndrome following umbilical cord blood transplantation for adults

et al. 2009

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Umbilical cord blood transplantation (CBT) is an alternative allogeneic haematopoietic stem cell transplantation (HSCT) strategy for patients with haematological diseases who do not have a matched related or unrelated donor and who need urgent transplantation. The value of CBT using myeloablative preparative regimens has already been confirmed among paediatric and adult patients (Laughlin et al, 2004;Rocha et al, 2004;Takahashi et al, 2004). However, conventional myeloablative preparative regimens are associated with significant morbidity and mortality, particularly in older patients or in those who have experienced extensive prior therapy or organ dysfunction associated with transplantation-related mortality. Various reduced-intensity preparative regimens that have been applied to such patients by several groups, including the authors of the present study, have proven feasible (Barker et al, 2003(Barker et al, , 2005Chao et al, 2004;Jacobsohn et al, 2004;Miyakoshi et al, 2004Miyakoshi et al, , 2007Yuji et al, 2005;Misawa et al, 2006;Ballen et al, 2007;Brunstein et al, 2007;Komatsu et al, 2007;Uchida et al, 2008).

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Section: Discussionmentioning

confidence: 99%

High incidence of haemophagocytic syndrome following umbilical cord blood transplantation for adults

et al. 2009

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“…25 HLA disparity in the GVH direction may augment alloimmune reactions, which evoke hypercytokinemia and macrophage activation and occasionally result in establishment of hemophagocytic syndrome, one of the major complications directly related to graft failure in recipients. [26][27][28] Indeed, a considerable number of patients showed hemophagocytosis in the BM with donor dominancy, leading to graft failure, even though we cannot exclude the possibility of graft rejection caused by recipient lymphocytes in some cases. In addition, among those who achieved donor cell engraftment, delayed neutrophil recovery was prominent for those with more HLA mismatch in the GVH direction rather than in the HVG direction.…”

Section: Discussionmentioning

confidence: 99%

Impact of HLA disparity in the graft-versus-host direction on engraftment in adult patients receiving reduced-intensity cord blood transplantation

Matsuno

Wake

Uchida

et al. 2009

Blood

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Delayed engraftment or graft failure is one of the major complications after cord blood transplantation (CBT). To investigate factors impacting engraftment, we conducted a retrospective analysis of adult patients who underwent reducedintensity CBT at our institute, in which preparative regimens mainly consisted of fludarabine, melphalan, and total body irradiation with graft-versus-host (GVH) disease prophylaxis using single calcineurin inhibitors. Among 152 evaluable patients, the cumulative incidence of neutrophil engraftment was 89%. High total nucleated cell and CD34 ؉ cell dose were associated with the faster speed and higher probability of engraftment. In addition, the degree of human leukocyte antigen (HLA) mismatch in the GVH direction was inversely associated with engraftment kinetics, whereas no statistically significant association was observed with the degree of HLA mismatch in the hostversus-graft direction. Similarly, the number of HLA class I antigens mismatched in the GVH direction, but not in the hostversus-graft direction, showed a negative correlation with engraftment kinetics. HLA disparity did not have significant impact on the development of GVH disease or survival. This result indicates the significant role of HLA disparity in the GVH direction in the successful engraftment, raising the novel mechanism responsible for graft failure in

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“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The frequency of HLH after SCT was reported as 4.1% in patients who had undergone autologous and allogeneic SCT 6 and was reported as 16.8% in patients who underwent CBT. 7 In the present study, the cumulative incidence of HLH was 4.3% in all patients and was 5.8% in patients who underwent CBT.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of HLH after SCT have not included many patients who received an etoposide-containing condition regimen. 8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Indeed, none of the patients in the report by Takagi et al received an etoposide-containing condition regimen. 6 These facts may also serve to support our speculation.…”

Section: Discussionmentioning

confidence: 99%

Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT

Kobayashi

Tanaka

Hashino

et al. 2013

Bone Marrow Transplant

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Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease of severe hyperinflammation caused by uncontrolled proliferation of activated lymphocytes and macrophages that secrete high amounts of inflammatory cytokines. HLH occurring after SCT is difficult to diagnose. It is characterized by severe clinical manifestations and high mortality. Despite current therapeutic approaches, outcomes remain poor. We analyzed the incidence and risk factors of HLH after SCT and the response to treatment and prognosis of 554 patients with HLH after SCT. The cumulative incidence of HLH after SCT was 4.3% (24/554). Use of etoposide in the conditioning regimen was only factor that reduced HLH after SCT (P ¼ 0.027). All patients who received autologous transplantation were successfully treated. Patients with liver dysfunction (for example, high total bilirubin level, prolonged prothrombin time and high level of fibrinogen degradation products) had a poor response to treatment for HLH. Physicians should be cautious of HLH, while not using etoposide for conditioning regimen.

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Hyperacute GVHD and emergence of peripheral CD3+CD56+ T cells and activated natural killer cells are useful markers for early diagnosis of post-transplant hemophagocytic syndrome

Cited by 10 publications

References 8 publications

High incidence of haemophagocytic syndrome following umbilical cord blood transplantation for adults

High incidence of haemophagocytic syndrome following umbilical cord blood transplantation for adults

Impact of HLA disparity in the graft-versus-host direction on engraftment in adult patients receiving reduced-intensity cord blood transplantation

Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT

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