Clinical impact of early absolute lymphocyte count after allogeneic stem cell transplantation

Kim, D. H.; Kim, J. G.; Baek, Jangsun; Sohn, Sang Ho; Suh, Jung–Won; Lee, K. S.; Lee, K. B.

doi:10.1200/jco.2004.22.90140.6632

Cited by 41 publications

(66 citation statements)

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“…Absolute lymphocyte count after allogeneic SCT has been found to correlate with acute or chronic graft-versus-host disease (GvHD). 29,30 Minimal relapse with GvHD suggests that immune reconstitution may be important for the GVT effect. 31 Some studies of RIST for MM showed a possible graft-versus-myeloma effect, 1,32 suggesting the immunemediated eradication of myeloma cells.…”

Section: Discussionmentioning

confidence: 99%

Early lymphocyte recovery predicts longer survival after autologous peripheral blood stem cell transplantation in multiple myeloma

Kim

et al. 2006

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Early lymphocyte recovery predicts longer survival after autologous peripheral blood stem cell transplantation in multiple myeloma

Kim

et al. 2006

Bone Marrow Transplant

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“…The transplant protocols, and supportive care maneuvers peri-transplant were conducted as previously described. 10,11 Among these cases (n ¼ 96), 51 consecutive patients underwent allogeneic SCT at the Asan Medical Center in Seoul, Korea, between January 1996 and August 2003, and 45 consecutive patients were transplanted at Kyungpook National University Hospital in Daegu, Korea, between September 1998 and January 2004. The clinical and laboratory data for the patients were retrieved from the allogeneic SCT database and medical records.…”

Section: Patients' Characteristicsmentioning

confidence: 99%

“…When a patient failed to respond to steroids, second-line therapy with mycophenolate mofetil (MMF), FK506, thalidomide or ATG was initiated as described previously. 10,11 The frontline treatment for cGVHD was prednisone (1-2 mg/kg/day; n ¼ 48, 50%) or the reintroduction of CSA to the therapeutic dose (n ¼ 6, 6%), both (n ¼ 37, 38%) or other agents (n ¼ 5, 5%). If further immunosuppressive treatment was needed to control GVHD, a salvage regimen was introduced according to the patient's clinical manifestations or toxicity profiles.…”

Section: Treatment For Gvhdmentioning

confidence: 99%

Time to first flare-up episode of GVHD can stratify patients according to their prognosis during clinical course of progressive- or quiescent-type chronic GVHD

Kim

et al. 2007

Bone Marrow Transplant

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GVHD-specific survival (GSS) has been investigated as a potential study end point to describe the clinical course and outcome of chronic GVHD (cGVHD). However, reaching this end point requires a long observation time. We hypothesized that the time to the first flare-up (FFU) of cGVHD (TTF) can be an alternative statistical end point to GSS. This retrospective study included 96 patients with a diagnosis of cGVHD from a cohort of 119 patients with a prior history of acute GVHD. The median TTF was 73 days after the diagnosis of cGVHD. The 2-year cumulative incidences of first, second and third episodes of flare-up (FU) during courses of cGVHD were estimated as 69.5, 46.4 and 22.1%. Those patients who did not have an episode of FU of cGVHD had 96.0% of 2-years GSS rate, while those with 1 and X2 episodes had 50.8 and 46.8%, respectively (P ¼ 0.001). Shorter TTF was associated with poor GSS and decreased overall survival. The shorter TTF during the course of cGVHD was significantly associated with extensive cGVHD (P ¼ 0.002), Hopkins' risk category (P ¼ 0.022) and progressive-type cGVHD (Po0.001) in multivariate analysis. We propose that TTF can be an alternative end point to GSS in cGVHD trials.

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“…9 Recent studies suggest that higher absolute lymphocyte counts shortly after SCT correlates with improved DFS and/ or overall survival. [10][11][12][13][14] The rate of immune reconstitution in patients with ovarian cancer after high-dose chemotherapy is an independent marker of time to progression, 15 and this may be related to the recent finding that immunosurveillance as assessed by the presence of tumor infiltrating lymphocytes (TILs) at the time of diagnosis is a strong predictor of disease-free survival in ovarian cancer. 16 It is likely that rapid recovery of T-cell function after SCT is critical for protection against infections and to promote graft-versustumor (GVT) activity.…”

mentioning

confidence: 99%

T-cell reconstitution and expansion after hematopoietic stem cell transplantation: ‘T’ it up!

Porter

June

2005

Bone Marrow Transplant

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Summary:Adoptive immunotherapy is the isolation and infusion of antigen-specific or nonspecific lymphocytes. Adoptive therapy with T cells may have a role in replacing, repairing, or enhancing immune function damaged by cytotoxic therapies, and rapid lymphocyte recovery may improve outcome after autologous and allogeneic stem cell transplantation (SCT). Recently, a plethora of information on the basic mechanisms of T-cell biology and regulation of cellular immune responses has emerged, permitting the development of new forms of adoptive cell therapy. Efficient ex vivo culture method for T-cell subsets affords the possibility of adoptive transfer of T cells engineered with enhanced capacity for central memory, effector cytotoxicity, Th1, Th2, veto cell, and T regulatory functions. Studies show that homeostatic Tcell proliferation is important for effective adoptive immunotherapy and pretreatment with chemotherapy may enhance the effects of infused T cells. Replicative senescence, in part due to telomere erosion, likely limits successful adoptive immunotherapy, though it may be possible to maintain T-cell pools by enforced expression of telomerase. Clinical trials now demonstrate that it is possible to enhance immune reconstitution after SCT with cytokines or infusions of ex vivo costimulated expanded T cells. These data all support the premise that adoptive therapy can accelerate reconstitution of cellular immunity with enhanced antitumor effects following SCT. Bone Marrow Transplantation (2005) 35, 935-942.

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Clinical impact of early absolute lymphocyte count after allogeneic stem cell transplantation

Cited by 41 publications

References 0 publications

Early lymphocyte recovery predicts longer survival after autologous peripheral blood stem cell transplantation in multiple myeloma

Early lymphocyte recovery predicts longer survival after autologous peripheral blood stem cell transplantation in multiple myeloma

Time to first flare-up episode of GVHD can stratify patients according to their prognosis during clinical course of progressive- or quiescent-type chronic GVHD

T-cell reconstitution and expansion after hematopoietic stem cell transplantation: ‘T’ it up!

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