Leukocyte adherence and rolling (A&R) per hour along the blood vessel wall was associated with cancer relapse and survival after hematopoietic cell transplant (HCT) for hematologic malignancies, according to the results of a prospective study published in the JAMA Dermatology.

“Dynamic biomarkers to predict relapse and inform treatment decisions after HCT are a major unmet clinical need,” the authors wrote in their report. During previous studies, the authors observed that higher leukocyte-endothelial cell interactions was associated with death after HCT.

“Assessing this dynamic marker could help patients at high risk for relapse who may benefit from interventions, such as early withdrawal of immunosuppression,” they noted.

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This single-center, prospective study included 56 patients who underwent HCT for hematologic malignancy, including acute lymphoblastic or myeloid leukemia, and myelodysplastic syndromes. Noninvasive skin videomicroscopy with a reflectance confocal microscope was performed a median of 40 days after HCT. A&R was measured by 2 blinded observers.

There were 37.5% of patients with high A&R. Rates of cancer relapse (HR, 4.24; 95% CI, 1.32-13.58; P =.02), shorter relapse-free survival (HR, 3.29; 95% CI, 1.26-8.55; P =.02), and higher cumulative incidence of relapse (HR, 4.24; 95% CI, 1.32-13.58; P =.02) were significantly associated with high A&R after correcting for baseline revised Disease Risk Index. Presence of acute graft vs host disease or topical or systemic steroid use did not affect these associations.

A high A&R was also significantly associated with shorter overall survival (HR, 3.06; 95% CI, 1.02-9.12; P =.05). The authors concluded that “leukocyte-endothelial interactions, visualized directly in skin after HCT, were associated with patient outcomes of relapse, relapse-free survival, and overall survival.”

Disclosures: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Saknite I, Patrinely JR, Zhao Z, et al. Association of leukocyte adhesion and rolling in skin with patient outcomes after hematopoietic cell transplantation using noninvasive reflectance confocal videomicroscopy. JAMA Dermatol. Published online March 26, 2022. doi:10.1001/jamadermatol.2022.0924