PMID- 30359733
OWN - NLM
STAT- MEDLINE
DCOM- 20200128
LR  - 20200128
IS  - 1523-6536 (Electronic)
IS  - 1083-8791 (Linking)
VI  - 25
IP  - 3
DP  - 2019 Mar
TI  - Lymphocyte Area Under the Curve as a Predictive Factor for Viral Infection after 
      Allogenic Hematopoietic Stem Cell Transplantation.
PG  - 587-593
LID - S1083-8791(18)30647-5 [pii]
LID - 10.1016/j.bbmt.2018.10.014 [doi]
AB  - Viral infection is a serious complication that can greatly affect patient 
      mortality and morbidity after allogenic hematopoietic stem cell transplantation 
      (allo-HSCT). For the early identification of patients at high risk for viral 
      infection, we evaluated the impact of lymphocyte area under the curve (AUC) value 
      as a new predictive factor for early immune reconstitution after allo-HSCT 
      against viral infection. This study included 286 patients who underwent their 
      first allo-HSCT at Kyoto University Hospital between 2005 and 2017. Lymphocyte 
      AUC from day 0 to day +15 was calculated in the analysis of human herpesvirus 6 
      (HHV-6), and lymphocyte AUC from day 0 to day +30 was calculated in the analysis 
      of other viruses (cytomegalovirus [CMV], adenovirus, BK virus, JC virus, and 
      varicella zoster virus). The risk factors for each viral reactivation/infection 
      were assessed by multivariate analysis. The median age at transplantation was 
      51years (range, 17 to 68 years). The median lymphocyte AUC was 63/muL (range, 0 to 
      5620/muL) at day +15 and 3880 (range, 0 to 118,260/muL) at day +30. An increase in 
      lymphocyte AUC was significantly associated with a high frequency of HHV-6 
      reactivation (P = .033) and a low frequency of CMV antigenemia (P = .014). No 
      apparent association was found between lymphocyte AUC and reactivation/infection 
      of other viruses. Aplastic anemia as a primary disease (hazard ratio [HR], 5.34; 
      P < .001) and cord blood as a donor source (HR, 3.05; P = .006) were other risk 
      factors for HHV-6 reactivation. Other risk factors for CMV antigenemia included 
      the occurrence of acute graft-versus-host disease (HR 2.21; P < .001) and 
      recipient age (HR 1.55; P = .017). Higher lymphocyte AUC at day +30 was 
      significantly associated with low treatment-related mortality (HR, .47; 
      P = .045). Lymphocyte AUC may be a good predictive factor for immune 
      reconstitution against CMV reactivation. It also provides valuable information 
      for predicting HHV-6 reactivation and treatment-related mortality.
CI  - Copyright (c) 2018 American Society for Blood and Marrow Transplantation. Published 
      by Elsevier Inc. All rights reserved.
FAU - Watanabe, Mizuki
AU  - Watanabe M
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Kanda, Junya
AU  - Kanda J
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan. Electronic address: jkanda16@kuhp.kyoto-u.ac.jp.
FAU - Hishizawa, Masakatsu
AU  - Hishizawa M
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Kondo, Tadakazu
AU  - Kondo T
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Yamashita, Kouhei
AU  - Yamashita K
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Takaori-Kondo, Akifumi
AU  - Takaori-Kondo A
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181022
PL  - United States
TA  - Biol Blood Marrow Transplant
JT  - Biology of blood and marrow transplantation : journal of the American Society for 
      Blood and Marrow Transplantation
JID - 9600628
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - *Area Under Curve
MH  - Cytomegalovirus/physiology
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects
MH  - Herpesvirus 6, Human/physiology
MH  - Humans
MH  - Immune Reconstitution
MH  - Lymphocytes
MH  - Male
MH  - Middle Aged
MH  - *Predictive Value of Tests
MH  - Transplantation, Homologous
MH  - Virus Activation
MH  - Virus Diseases/*etiology
MH  - Young Adult
OTO - NOTNLM
OT  - CMV antigenemia
OT  - HHV-6
OT  - Immune reconstitution
OT  - Lymphocyte AUC
OT  - Viral reactivation
EDAT- 2018/10/26 06:00
MHDA- 2020/01/29 06:00
CRDT- 2018/10/26 06:00
PHST- 2018/08/28 00:00 [received]
PHST- 2018/10/15 00:00 [accepted]
PHST- 2018/10/26 06:00 [pubmed]
PHST- 2020/01/29 06:00 [medline]
PHST- 2018/10/26 06:00 [entrez]
AID - S1083-8791(18)30647-5 [pii]
AID - 10.1016/j.bbmt.2018.10.014 [doi]
PST - ppublish
SO  - Biol Blood Marrow Transplant. 2019 Mar;25(3):587-593. doi: 
      10.1016/j.bbmt.2018.10.014. Epub 2018 Oct 22.