Elevated bone marrow eosinophil count is associated with high incidence of severe acute GvHD after allogeneic hematopoietic stem cell transplantation

Abstract

Predicting severe acute GvHD (aGvHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is challenging but critical. Mild aGvHD may have a favorable impact on relapse, whereas severe aGvHD is associated with poor outcomes. The aim of this study was to evaluate whether elevated eosinophil count in the bone marrow (BM) at 1 month after HSCT is associated with a high incidence of new and severe aGvHD. We enrolled 101 consecutive patients; median age was 50 years, and 50.5% patients were male. The median eosinophil concentration in BM at 1 month after HSCT was 1.1% (quartile 0.4-2.2%). The adjusted hazards ratio at 95% confidence interval for severe aGvHD was 1.26 (1.12-1.42, P<0.001), per 1% increase in eosinophil concentration, and 3.76 (1.41-10.05, P=0.008) for the high-risk group at a cutoff value of 4.0%. In addition, the predictive accuracy described by area under the curve of receiver operating characteristics, increased from 0.784 to 0.866 (P=0.033) with the increasing concentration of eosinophils. In conclusion, elevated concentration of eosinophils in BM was associated with high incidence and predictive accuracy of severe aGvHD. BM eosinophil concentration can be one of the key markers to predict aGvHD.

Diagnostic spectrum of hypereosinophilia based on bone marrow pathology: 10 years' experience at a tertiary care hospital

“…McNeel et al 13 reported that HE from PB often is the presenting sign of acute graft versus host disease (aGVHD) and increased IL‐5 and IL‐5 mRNA expression in blood and skin biopsies were suggestive of a correlation between eosinophilia and aGVHD. There are also reports that eosinophilia from BM not PB, is associated with the development of aGVHD 14,15 . Based on these findings assessment of eosinophilia by BM examination after BMT serves a predictive role for the clinical course after BMT.…”

“…There are also reports that eosinophilia from BM not PB, is associated with the development of aGVHD. 14,15 Based on these findings assessment of eosinophilia by BM examination after BMT serves a predictive role for the clinical course after BMT. On the contrary, Sato et al 16 suggested that presentation of eosinophilia can be a favorable prognostic marker after BMT.…”

CD38 expression is an important prognostic marker in diffuse large B‐cell lymphoma

“…To provide simple risk stratification, we divided our patients into two risk groups (CD38 HIGH and CD38 LOW ) by employing the survival classification and regression tree (CART) analysis. CART analysis is an empirical statistical technique based on recursive partitioning analysis and it is useful to arrive at clinical decisions and risk stratification models 10,11 . The two patient risk groups were treated as an ordered categorical variables, and the impacts on endpoints were evaluated using the above‐mentioned methods.…”

“…CART analysis is an empirical statistical technique based on recursive partitioning analysis and it is useful to arrive at clinical decisions and risk stratification models. 10,11 The two patient risk groups were treated as an ordered categorical variables, and the impacts on endpoints were evaluated using the above-mentioned methods. For comparison between groups, patients and disease characteristics were compared using the Mann-Whitney U test for continuous variables and chi-square test for categorical variables.…”