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Status of Natural Killer Cell Recovery in Day 21 Bone Marrow after Allogeneic Hematopoietic Stem Cell Transplantation Predicts Clinical Outcome
Authors:Norimichi Hattori  Bungo Saito  Yohei Sasaki  Shotaro Shimada  So Murai  Maasa Abe  Yuta Baba  Megumi Watanuki  Shun Fujiwara  Yukiko Kawaguchi  Nana Arai  Nobuyuki Kabasawa  Hiroyuki Tsukamoto  Yui Uto  Hirotsugu Ariizumi  Kouji Yanagisawa  Hiroshi Harada  Tsuyoshi Nakamaki
Abstract:Rapid immune recovery following allogeneic hematopoietic stem cell transplantation (allo-HSCT) is important for clinical outcome prediction. In most studies, immune recovery after allo-HSCT is monitored via peripheral blood. However, few reports regarding the status of absolute lymphocyte subsets in the bone marrow (BM) microenvironment have been undertaken. Therefore, we evaluated the clinical impact of immune recovery in the early period following allo-HSCT using BM samples. We showed that delayed natural killer cell recovery was independently associated with a poor prognosis for overall survival (hazard ratio [HR], 3.07; 95% confidence interval [CI], 1.37- 6.89; P?=?.007), progression-free survival (HR, 3.42; 95% CI, 1.47-7.94; P?=?.004), and nonrelapse mortality (HR, 6.68; 95% CI, 1.82-25.0; P?=?.004) by multivariate analysis. In addition, low NK cell counts were associated with the presence of 1 or more bacterial, viral, or fungal infections. Our results indicate that investigating absolute lymphocyte subsets in BM in the early phase following allo-HSCT can be useful for predicting and improving survival outcomes.
Keywords:Natural killer cells  Immune recovery  Immune reconstitution  Lymphocyte subset  Allogeneic hematopoietic stem cell transplantation
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