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Tsumita K, Takagi S, Asano-Mori Y, Watanabe O, Shindo M, Yamaguchi K, Yuasa M, Kageyama K, Kaji D, Taya Y, Nishida A, Ishiwata K, Yamamoto H, Araoka H, Yamamoto G, Makino S, Wake A, Uchida N, Taniguchi S, Koike Y. Long-term lymphocyte subset number reconstitution is unique but comparable between umbilical cord blood and unrelated bone marrow transplantation. Int J Hematol 2024; 119:573-582. [PMID: 38407785 DOI: 10.1007/s12185-024-03727-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 01/27/2024] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
The number of umbilical cord blood transplantation (U-CBT) procedures has been growing annually, but little research has been done on long-term immune recovery after U-CBT. Infection risk is high in U-CBT recipients, and this can be partially attributed to immature immunocompetent cells in umbilical cord blood. In this study, we analyzed lymphocyte subset (LST) number to determine the long-term recovery timeline. We included 36 U-CBT and 10 unrelated bone marrow transplantation (U-BMT) recipients who survived more than 2 years after transplantation, and followed them for up to 10 years post-transplant. Recovery kinetics in the early phase post-transplant was different for each LST. Recovery of CD19+ B cells was faster after U-CBT than after U-BMT in the first 5 years after transplantation. Although CD4+ T cells increased in the first several months after U-CBT, long-term cell count recovery was impaired in approximately 20% of patients. Thus, although the LST recovery pattern after U-CBT was unique, LST number recovery was statistically comparable between U-CBT and U-BMT past 5 years post-transplantation.
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Affiliation(s)
- Keiko Tsumita
- Department of Clinical Laboratory, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 1050001, Japan
| | - Shinsuke Takagi
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Yuki Asano-Mori
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Otoya Watanabe
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Michiho Shindo
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kyosuke Yamaguchi
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | | | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Hisashi Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
| | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Atsushi Wake
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | | | - Yukako Koike
- Department of Clinical Laboratory, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 1050001, Japan.
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Konuma T, Monna‐Oiwa M, Takano K, Isobe M, Kato S, Takahashi S, Nannya Y. Optimal time and threshold of absolute lymphocyte count recovery as a prognostic factor after single‐unit cord blood transplantation in adults. EJHAEM 2022; 3:191-198. [PMID: 35846188 PMCID: PMC9176115 DOI: 10.1002/jha2.372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 01/25/2023]
Abstract
We retrospectively evaluated the optimal time and threshold of absolute lymphocyte count (ALC) recovery as a prognostic factor in 174 adult patients who received single‐unit cord blood transplantation (CBT) at our institute. We analyzed the impact of ALC ≥300, ≥600, and ≥900/μl by 30 and 60 days on transplant outcomes. Multivariate analysis showed that only ALC ≥300/μl at 60 days was significantly associated with overall mortality (hazard ratio, 0.24; p = 0.001) following CBT. The optimal time point to use ALC recovery as a prognostic tool following CBT could be later than those following adult donor transplantation.
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Affiliation(s)
- Takaaki Konuma
- Department of Hematology/Oncology The Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Maki Monna‐Oiwa
- Department of Hematology/Oncology The Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Kosuke Takano
- Department of Hematology/Oncology The Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Masamichi Isobe
- Department of Hematology/Oncology The Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Seiko Kato
- Department of Hematology/Oncology The Institute of Medical Science The University of Tokyo Tokyo Japan
- Division of Clinical Precision Research Platform The Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Satoshi Takahashi
- Department of Hematology/Oncology The Institute of Medical Science The University of Tokyo Tokyo Japan
- Division of Clinical Precision Research Platform The Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Yasuhito Nannya
- Department of Hematology/Oncology The Institute of Medical Science The University of Tokyo Tokyo Japan
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