Assessment of leukocytes adherent to and rolling along vessel wall may help predict outcomes after HCT for hematologic cancer
WEDNESDAY, April 6, 2022 (HealthDay News) — For patients who have undergone hematopoietic cell transplantation (HCT) for hematologic cancer, leukocyte-endothelial interactions visualized directly in skin may help predict prognosis, according to a study published online March 26 in JAMA Dermatology to coincide with the annual meeting of the American Academy of Dermatology, held from March 25 to 29 in Boston.
Inga Saknite, Ph.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues conducted a prospective study involving patients who had HCT for hematologic cancer. Patients underwent noninvasive skin videomicroscopy; dermal microvascular flow was recorded with a reflectance confocal microscope. Leukocytes adherent to and rolling along the vessel wall (A&R) were counted per hour in 56 patients.
The researchers found that 21 patients had high A&R, and 35 patients had low A&R. Patients with high A&R had increased rates of relapse, reduced relapse-free survival, and reduced overall survival (hazard ratios, 4.24, 3.29, and 3.06, respectively) after correcting for the revised Disease Risk Index. After correcting for possible confounders, steroid treatment, and acute graft-versus-host disease status, these associations persisted. The new imaging biomarker (A&R) accounted for 82 to 95 percent of the prognostic information to predict each outcome in the prognostic adequacy calculation. In contrast, in the same model, the best existing clinical predictor routinely available (the revised Disease Risk Index) accounted for 10 to 28 percent of the prognostic information.
“Our study raises the prospect of a new application of so-called diagnostic optical biopsy with a special confocal microscope brought to stem cell and bone marrow transplant patients for noninvasive inspection of their skin right at the bedside,” a coauthor said in a statement.
One author disclosed financial ties to the biopharmaceutical industry.
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