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Allografting

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

Bone Marrow Transplantation volume 47, pages 387–394 (2012)Cite this article

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.

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Acknowledgements

This study was supported by a Ministry of Health, Labor and Welfare of Japan Grant-in-Aid (KM).

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Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

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

  2. Department of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    M Ito

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  1. N Imahashi
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Correspondence to N Imahashi.

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Imahashi, N., Inamoto, Y., Ito, M. et al. Clinical significance of hemophagocytosis in BM clot sections during the peri-engraftment period following allogeneic hematopoietic SCT. Bone Marrow Transplant 47, 387–394 (2012). https://doi.org/10.1038/bmt.2011.95

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