Early recovery of lymphocyte count after hematopoietic stem cell
transplantation is a potential risk factor for chronic graft-versus-host
disease
Abstract
Few studies have investigated the association between severity of
lymphopenia and clinical outcome during chemotherapy or hematopoietic
stem cell transplantation (HSCT). We investigated this issue by
retrospectively analyzing pediatric patients who received
allogeneic-HSCT (allo-HSCT) using a newly developed parameter called the
LD-index that combines both the duration and the intensity of
lymphopenia. A total of 92 patients underwent allo-HSCT in our hospital
from April 2007 to August 2019. The median age at HSCT was 10.3 years
(range 0.4 – 28.1). The median LD-index was 9,285 (range 2,217 –
36,064). A significantly high association was observed between the
LD-index and the incidence of chronic graft-versus-host disease (GvHD)
(p = 0.0045). Analysis of predictive factors for chronic GvHD was
carried out using univariate analysis. Lower LD-index, donor source and
duration (days) of lymphopenia were found to be significant factors
associated with chronic GvHD. Multivariate analysis, however, only
identified an association between lower LD-index and increased incidence
of chronic GvHD (p = 0.004). In conclusion, the duration and the
intensity of lymphopenia after allo-HSCT have an effect on the
development of chronic GvHD.