L-index as a novel index to evaluate both the intensity and duration of lymphopenia after allogeneic hematopoietic stem cell transplantation

S. I. Kimura, H. Wada, K. Sakamoto, M. Ashizawa, M. Sato, K. Terasako, H. Nakasone, M. Kikuchi, S. Okuda, S. Kako, Rie Yamazaki, K. Oshima, Y. Tanaka, A. Tanihara, J. Nishida, Y. Kanda

Research output: Contribution to journalArticle

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Abstract

We retrospectively investigated L-index, which evaluates both the intensity and duration of lymphopenia after allogeneic hematopoietic stem cell transplantation (HSCT) (n = 50). L-index was defined as the area over the lymphocyte curve during lymphopenia (absolute lymphocyte count < 700/μL). We calculated the L-index from the start of conditioning to day 30 - L-index(30) - and to day 100 - L-index(100) - after HSCT. Multivariate analysis revealed that human leukocyte antigen mismatched donor, female gender, and non-lymphoid disease were significantly associated with high L-index(30). Grade III-IV acute graft-versus-host disease, alemtuzumab-containing regimen, and non-lymphoid disease were identified as independent significant factors for high L-index(100). Cytomegalovirus (CMV) antigenemia was detected > 3 cells/2 slides by C10/11 method in 30 patients (CMV-AG ≥ 3 group) and was not detected in 20 patients (CMV-AG < 3 group). Although no significant difference was seen in absolute lymphocyte count on day 30 between the 2 groups, the L-index(30) was significantly higher in the CMV-AG ≥ 3 group than in the CMV-AG < 3 group (P = 0.050). L-index(30) was identified as an independent factor on CMV reactivation in multivariate analysis, when it was treated as a dichotomous variable with a cut-off value of 22,318, determined by receiver operating characteristic curve analysis. In conclusion, both the intensity and duration of lymphopenia in early phase after HSCT evaluated on the basis of L-index(30) showed significant association with CMV reactivation.

Original languageEnglish
Pages (from-to)364-373
Number of pages10
JournalTransplant Infectious Disease
Volume14
Issue number4
DOIs
Publication statusPublished - 2012 Aug 1
Externally publishedYes

Fingerprint

Lymphopenia
Hematopoietic Stem Cell Transplantation
Lymphocyte Count
ROC Curve
Multivariate Analysis
Lymphocytes

Keywords

  • Absolute lymphocyte count
  • Allogeneic hematopoietic stem cell transplantation
  • Cytomegalovirus antigenemia
  • L-index
  • Lymphopenia

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Cite this

L-index as a novel index to evaluate both the intensity and duration of lymphopenia after allogeneic hematopoietic stem cell transplantation. / Kimura, S. I.; Wada, H.; Sakamoto, K.; Ashizawa, M.; Sato, M.; Terasako, K.; Nakasone, H.; Kikuchi, M.; Okuda, S.; Kako, S.; Yamazaki, Rie; Oshima, K.; Tanaka, Y.; Tanihara, A.; Nishida, J.; Kanda, Y.

In: Transplant Infectious Disease, Vol. 14, No. 4, 01.08.2012, p. 364-373.

Research output: Contribution to journalArticle

Kimura, SI, Wada, H, Sakamoto, K, Ashizawa, M, Sato, M, Terasako, K, Nakasone, H, Kikuchi, M, Okuda, S, Kako, S, Yamazaki, R, Oshima, K, Tanaka, Y, Tanihara, A, Nishida, J & Kanda, Y 2012, 'L-index as a novel index to evaluate both the intensity and duration of lymphopenia after allogeneic hematopoietic stem cell transplantation', Transplant Infectious Disease, vol. 14, no. 4, pp. 364-373. https://doi.org/10.1111/j.1399-3062.2012.00727.x
Kimura, S. I. ; Wada, H. ; Sakamoto, K. ; Ashizawa, M. ; Sato, M. ; Terasako, K. ; Nakasone, H. ; Kikuchi, M. ; Okuda, S. ; Kako, S. ; Yamazaki, Rie ; Oshima, K. ; Tanaka, Y. ; Tanihara, A. ; Nishida, J. ; Kanda, Y. / L-index as a novel index to evaluate both the intensity and duration of lymphopenia after allogeneic hematopoietic stem cell transplantation. In: Transplant Infectious Disease. 2012 ; Vol. 14, No. 4. pp. 364-373.
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AU - Kimura, S. I.

AU - Wada, H.

AU - Sakamoto, K.

AU - Ashizawa, M.

AU - Sato, M.

AU - Terasako, K.

AU - Nakasone, H.

AU - Kikuchi, M.

AU - Okuda, S.

AU - Kako, S.

AU - Yamazaki, Rie

AU - Oshima, K.

AU - Tanaka, Y.

AU - Tanihara, A.

AU - Nishida, J.

AU - Kanda, Y.

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N2 - We retrospectively investigated L-index, which evaluates both the intensity and duration of lymphopenia after allogeneic hematopoietic stem cell transplantation (HSCT) (n = 50). L-index was defined as the area over the lymphocyte curve during lymphopenia (absolute lymphocyte count < 700/μL). We calculated the L-index from the start of conditioning to day 30 - L-index(30) - and to day 100 - L-index(100) - after HSCT. Multivariate analysis revealed that human leukocyte antigen mismatched donor, female gender, and non-lymphoid disease were significantly associated with high L-index(30). Grade III-IV acute graft-versus-host disease, alemtuzumab-containing regimen, and non-lymphoid disease were identified as independent significant factors for high L-index(100). Cytomegalovirus (CMV) antigenemia was detected > 3 cells/2 slides by C10/11 method in 30 patients (CMV-AG ≥ 3 group) and was not detected in 20 patients (CMV-AG < 3 group). Although no significant difference was seen in absolute lymphocyte count on day 30 between the 2 groups, the L-index(30) was significantly higher in the CMV-AG ≥ 3 group than in the CMV-AG < 3 group (P = 0.050). L-index(30) was identified as an independent factor on CMV reactivation in multivariate analysis, when it was treated as a dichotomous variable with a cut-off value of 22,318, determined by receiver operating characteristic curve analysis. In conclusion, both the intensity and duration of lymphopenia in early phase after HSCT evaluated on the basis of L-index(30) showed significant association with CMV reactivation.

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