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Endothelial function testing before conditioning therapy is useful for predicting transplant-related complications after allogeneic hematopoietic cell transplantation

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Abstract

Background

Hematopoietic stem cell transplantation (HSCT) is a useful tool for the treatment of hematologic malignancies. However, transplantation-related complications are the main cause of non-relapse mortality. Previous reports suggest that endothelial damage is related to early complications after HSCT. Non-invasive reactive hyperemia peripheral arterial tonometry (RH-PAT) was performed to evaluate endothelial function as a predictive marker for these complications.

Methods

The reactive hyperemia index (RHI) obtained from RH-PAT was evaluated before the conditioning regimen. The relationship between the RHI and the appearance of engraftment syndrome, thrombotic microangiopathy, and acute graft-versus-host disease (aGVHD) was assessed. Receiver operating characteristic curve analysis showed that an RHI value of 1.58 was the optimal cut-off for predicting transplantation-related complications.

Results

In total, 49 patients (22 acute myelogenous leukemia, 7 acute lymphocytic leukemia, 6 myelodysplastic syndrome, 6 adult T-cell leukemia, 6 non-Hodgkin lymphoma, and 2 others) were enrolled; 34 had a normal RHI (≥ 1.59), and 15 had an abnormally low RHI (≤ 1.58). Thrombotic microangiopathy (20.2% vs 0.0%, P = 0.025) and aGVHD (80.0% vs 41.2%, P = 0.015) were significantly more frequent in patients with a low RHI.

Conclusion

Endothelial dysfunction assessed by RH-PAT before HSCT was able to predict transplantation-related complications.

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Data availability statement

Data available on reasonable request from the corresponding author.

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Acknowledgements

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Authors and Affiliations

  1. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan

    Shojiro Haji, Motoaki Shiratsuchi, Mariko Tsuda, Hiroki Muta, Toru Masuda, Yasuhiro Nakashima & Yoshihiro Ogawa

  2. Department of Hematology, Iizuka Hospital, Iizuka, 820-8505, Japan

    Motoaki Shiratsuchi & Akiko Takamatsu

Authors
  1. Shojiro Haji
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Contributions

S.H., A.T., and M.S. made substantial contributions to conception and design, acquisition of data, and analysis and interpretation of data. S.H., A.T., and M.S. made substantial contributions to the acquisition of data, and analysis and interpretation of data. S.H. and M.S. wrote the article, and all authors made substantial contributions to editing and revising the article. All authors have approved the final version of the article. M.S. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Motoaki Shiratsuchi.

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Conflict of interest

Shojiro Haji received honoraria/lecture fees from Kyowa Kirin unrelated to this study. Motoaki Shiratsuchi received research grant support from Chugai, Kyowa Kirin, Daiichi Sankyo, MSD, and SRL, and honoraria/lecture fees from Otsuka, Chugai, Kyowa Kirin, Ono, and Sanofi, unrelated to this study. Mariko Tsuda received honoraria/lecture fees from Otsuka, unrelated to this study. Yasuhiro Nakashima received research grants from the Japanese Society of Hematology, and research grant support from Chugai, Kyowa Kirin, Daiichi Sankyo, and SRL, and honoraria/lecture fees from Otsuka, Chugai, Kyowa Kirin, Ono, and Sanofi, unrelated to this study. Yoshihiro Ogawa received research grant support from Kyowa Kirin, Taisho, Mochida, Cosmic Corporation, Fujifilm, Mitsubishi Tanabe, AstraZeneca, Nippon Boehringer Ingelheim, Eisai, Abbott, Chugai, Pfizer, Tsumura, Otsuka, Taiho, Zeria, and Fujiyakuhin, and honoraria/lecture fees from Novo Nordisk Pharma and Taisho, unrelated to this study. The other authors have no conflicts of interest to declare.

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Haji, S., Shiratsuchi, M., Takamatsu, A. et al. Endothelial function testing before conditioning therapy is useful for predicting transplant-related complications after allogeneic hematopoietic cell transplantation. Int J Hematol 117, 438–445 (2023). https://doi.org/10.1007/s12185-022-03498-3

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  • DOI: https://doi.org/10.1007/s12185-022-03498-3

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