title: Peripheral blood eosinophilia has a favorable prognostic impact on transplant outcomes after allogeneic peripheral blood stem cell transplantation.
abstract: Peripheral eosinophilia after allogeneic stem cell transplant (ASCT) may reflect the activation of the Th2 cytokine pathway. A retrospective analysis was performed to evaluate the impact of early- (before day 100: EEo) or late-onset (beyond day 100: LEo) eosinophilia (> or =0.5 x 10(9)/L in peripheral blood) on transplant outcomes after peripheral blood SCT (PBSCT) in 237 patients. The incidence of EEo and LEo was 43% at day 100 and 62% at 2 years, respectively. Compared with patients without LEo, improved transplant outcomes were observed in patients with LEo: better overall survival (OS; 86% versus 41%, P = 5 x 10(-11)), lower nonrelapse mortality (NRM; 10% versus 37%, P = 3 x 10(-6)), lower relapse incidence (11% versus 31%, P = 3 x 10(-5)), and higher GVHD-specific survival (GSS; 90% versus 64%, P = 1 x 10(-6)) were observed. In addition, similar finding was observed when transplant outcomes were analyzed according to the occurrence of eosinophilia at the onset of cGVHD. The multivariate analyses confirmed a favorable implication of LEo on OS, NRM, and GSS. LEo was associated with: (1) less severe chronic GVHD (cGVHD), (2) higher prevalence of autoantibodies, and (3) rapid lymphocyte count recovery after ASCT. In summary, the development of eosinophila after allogeneic PBSCT seemed to be a prognostic marker for improving transplant outcome.
authors.affiliation: Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, Canada. drkim@medimail.co.kr
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Kim
authors.forename: Gizelle
authors.initials: G
authors.lastname: Popradi
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Vikas
authors.initials: V
authors.lastname: Gupta
authors.forename: John
authors.initials: J
authors.lastname: Kuruvilla
authors.forename: Janice
authors.initials: J
authors.lastname: Wright
authors.forename: Hans A
authors.initials: HA
authors.lastname: Messner
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Lipton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004802:Eosinophilia / Q000097:blood* / Q000276:immunology / Q000401:mortality; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood* / Q000276:immunology / Q000401:mortality / Q000628:therapy; D019337:Hematologic Neoplasms / Q000097:blood* / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D015994:Incidence; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism; D014184:Transplantation, Homologous