ArticleClinical and experimental medicine2026
Tacrolimus has better performance in B cell reconstitution after allo-HSCT compared to cyclosporine A: a real-world study.
Article in Clinical and experimental medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
B-cell reconstitution is closely associated with prognosis, infection risk, and graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the impact of different calcineurin inhibitors (CNIs) on B-cell recovery remains unclear. We retrospectively analyzed 312 allo-HSCT recipients receiving cyclosporine (CsA, n = 211) or tacrolimus (FK506, n = 101). B-cell proportions in bone marrow and peripheral lymphocyte subsets were compared, and propensity score matching was applied to balance confounders. Multivariate analysis demonstrated that FK506 was independently associated with superior B-cell reconstitution at 3 months (OR 2.93, 95% CI 1.49-5.76, p = 0.010) and 4 months post-transplant (OR 3.53, 95% CI 1.11-11.15, p = 0.024). Higher B-cell proportions at 3-5 months were associated with a significantly lower risk of viral infection. Mediation analysis further revealed that improved B-cell reconstitution at day + 90 partially mediated the protective effect of FK506 against viral infection. These findings suggest that FK506 promotes improved B-cell recovery and may reduce viral infection risk after allo-HSCT.
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