Effect of absolute monocyte count post-transplant on the outcome of patients with acute myeloid leukemia undergoing myeloablative allogeneic hematopoietic stem cell transplant with busulfan and cyclophosphamide conditioning
“…Some authors have recommended monitoring the prognosis of HSCT based on CBC. Despite AMC > 0.3–0.5 × 10 9 /L after HSCT being associated with better survival, a more consistent result was seen when lymphocyte subsets were examined [ 102 , 103 ]. Studies have shown that a minimum level of ALC of 300 × 10 9 /L or higher improves OS and is associated with fewer infectious complications after transplantation [ 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 ].…”
Numerous prognostic indexes have been developed in hematological diseases based on patient characteristics and genetic or molecular assessment. However, less attention was paid to more accessible parameters, such as neutrophils, lymphocytes, monocytes, and platelet counts. Although many studies have defined the role of neutrophil-to-lymphocyte or platelet-to-lymphocyte in lymphoid malignancies, few applications exist for myeloid neoplasm or hematopoietic stem cell transplantation procedures. In this review, we synthesized literature data on the prognostic value of count blood cells in myeloid malignancies and hematopoietic stem cell transplantation in the context of classical prognostic factors and clinical outcomes.
“…Some authors have recommended monitoring the prognosis of HSCT based on CBC. Despite AMC > 0.3–0.5 × 10 9 /L after HSCT being associated with better survival, a more consistent result was seen when lymphocyte subsets were examined [ 102 , 103 ]. Studies have shown that a minimum level of ALC of 300 × 10 9 /L or higher improves OS and is associated with fewer infectious complications after transplantation [ 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 ].…”
Numerous prognostic indexes have been developed in hematological diseases based on patient characteristics and genetic or molecular assessment. However, less attention was paid to more accessible parameters, such as neutrophils, lymphocytes, monocytes, and platelet counts. Although many studies have defined the role of neutrophil-to-lymphocyte or platelet-to-lymphocyte in lymphoid malignancies, few applications exist for myeloid neoplasm or hematopoietic stem cell transplantation procedures. In this review, we synthesized literature data on the prognostic value of count blood cells in myeloid malignancies and hematopoietic stem cell transplantation in the context of classical prognostic factors and clinical outcomes.
“…Considering that KLRG1 is induced in highly cytotoxic and proliferative effector CD8 + T cells 49,50 and KLRG1 + CD8 + T cells could exert robust cytotoxic potential against tumor cells 51,52 , all these evidences suggested that the decrease of MRD-_CD8 clusters might be associated with the decrease of cytotoxicity of CD8 + T cells and contribute to MRD positivity after allo-HSCT. Some studies revealed that absolute monocyte count (AMC) increased at diagnosis or on posttransplant day 15 was associated with the poor survival of AML patients 53 ; however, another study found that a higher AMC after allo-HSCT was associated with improved survival of AML patients 54 . Thus, the impact of monocyte on post-transplant outcomes was controversial, and the association between monocyte and MRD positivity was unknown.…”
Measurable residual disease (MRD) is a powerful prognostic factor for relapse in acute myeloid leukemia (AML). We applied the single-cell RNA sequencing to bone marrow (BM) samples from MRD-positive (n = 20) and MRD-negative (n = 12) patients after allogeneic hematopoietic stem cell transplantation. A comprehensive immune landscape with 184,231 cells was created. Compared with CD8+ T cells enriched in MRD-negative patients (MRD-_CD8), those enriched in MRD-positive patients (MRD+_CD8) showed lower expression levels of cytotoxicity-related genes. Monocyte clusters (MRD+_M) and B-cell clusters (MRD+_B) were both enriched in MRD-positive patients. Conversion from an MRD-positive state to an MRD-negative state accompanied with the increase of MRD-_CD8 clusters and vice versa. MRD-enriched cell clusters employed the macrophage migration inhibitory factor pathway to regulate MRD-_CD8 clusters. These firstly revealed characteristics of immune cell landscape in MRD positivity, which will enable a better understanding of the immune mechanisms for MRD conversion.
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