Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation in multiple myeloma or non-Hodgkin lymphoma

Porrata, Luis F.; Gertz, Morie A.; Inwards, David J.; Litzow, Mark R.; Lacy, Martha Q.; Tefferi, Ayalew; Gastineau, Dennis A.; Dispenzieri, Angela; Ansell, Stephen M.; Micallef, Ivana N.; Geyer, Susan; Markovic, Svetomir N.

doi:10.1182/blood.v98.3.579

Cited by 260 publications

(237 citation statements)

References 26 publications

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“…Our findings contradict prior reports 5,8 of a correlation between early lymphocyte recovery and improved PFS in patients undergoing AHCT. A recently published study 12 Lymphocyte count in transplanted HL patients T Seshadri et al also failed to demonstrate an association between ALC-15 and PFS in patients with non-Hodgkin's lymphoma (NHL) undergoing AHCT.…”

Section: Discussioncontrasting

confidence: 57%

“…4 Recovery of PBL (40.5 Â 10 9 per liter by day 15 post-AHCT) has also been related to improved PFS and overall survival (OS) in transplanted HL patients. 5,6 These findings have also been demonstrated in patients with other lymphoma subtypes 7 and myeloma 8 undergoing AHCT. Our study was undertaken to further evaluate the relationship between the absolute lymphocyte count (ALC) at the time of apheresis and ALC recovery at two time points after AHCT, with PFS in a group of uniformly treated patients with relapsed or refractory HL.…”

Section: Introductionsupporting

confidence: 59%

“…Similar to other studies was the lack of association between the CD34 cell dose and engraftment times on ALC-15 recovery. 5,8 Like others, 3,[15][16][17] we have shown that patients with chemotherapy-sensitive disease have an improved PFS compared to patients who have SD. B symptoms at relapse have been shown to be associated with PFS in several studies, 3,18,19 however we and others 20,21 did not find a strong association between B symptoms at relapse and PFS.…”

Section: Discussionmentioning

confidence: 94%

“…They were dichotomized at 0.5 Â 10 9 per liter and at the median based on prior reports. 8 PFS estimates were calculated using Kaplan-Meier method and compared using log-rank test. The association between PFS and ALC, ALC-15 and ALC-90 controlling for response to salvage therapy was performed using Cox proportional hazards model.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between absolute lymphocyte count with PFS in patients with Hodgkin's lymphoma undergoing autologous hematopoietic cell transplant

Seshadri

Pintilie

Keating

et al. 2008

Bone Marrow Transplant

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Previous reports in Hodgkin's lymphoma (HL) patients undergoing autologous hematopoietic cell transplantation (AHCT) have demonstrated a significant association between the absolute lymphocyte count at day 15 (ALC-15) with survival. To evaluate this finding further, we analyzed 146 patients with relapsed/refractory HL who underwent AHCT to evaluate the relationship between lymphocyte counts at apheresis and at two time points (days 15 and 90) after AHCT with PFS. We found no association between the ALC-15 and the ALC-90 with PFS. We found lymphocyte counts at apheresis and disease sensitive to salvage chemotherapy were predictive of PFS. In conclusion, our study does provide some support for the theory that the immune system may be important in disease control but further and more detailed studies in this area are required.

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Section: Discussioncontrasting

confidence: 57%

Section: Introductionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The relationship between absolute lymphocyte count with PFS in patients with Hodgkin's lymphoma undergoing autologous hematopoietic cell transplant

Seshadri

Pintilie

Keating

et al. 2008

Bone Marrow Transplant

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“…Whether this observation may be explained by tumor-mediated suppression of nonmalignant T cells, diminished thymic output of naïve T cells and compensatory homeostatic expansion of oligoclonal peripheral T cells, or some other mechanism, is unknown [47]. As lymphopenia is an adverse prognostic factor in many hematologic malignancies [59][60][61][62][63][64], and undoubtedly contributes to the infectious complications observed in CTCL, improved understanding of the causative mechanism(s) leading to this dramatic loss of T-cell diversity may have significant therapeutic implications.…”

Section: Immunopathogenesismentioning

confidence: 99%

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Wilcox

2011

American J Hematol

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Disease overview: Cutaneous T‐cell lymphomas are a heterogenous group of T‐cell lymphoproliferative disorders involving the skin, the majority of which may be classified as Mycosis fungoides (MF) or Sézary syndrome (SS).Diagnosis: The diagnosis of MF or SS requires the integration of clinical and histopathologic data.Risk‐adapted therapy: Tumor, node, metastasis, and blood (TNMB) staging remains the most important prognostic factor in MF/SS and forms the basis for a “risk‐adapted,” multidisciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin‐directed therapies is preferred, as both disease‐specific and overall survival for these patients is favorable. In contrast, patients with advanced‐stage disease with significant nodal, visceral, or blood involvement are generally approached with biologic‐response modifiers, denileukin diftitox, and histone deacetylase inhibitors before escalating therapy to include systemic, single‐agent chemotherapy. Multiagent chemotherapy may be used for those patients with extensive visceral involvement requiring rapid disease control. In highly‐selected patients with disease refractory to standard treatments, allogeneic stem‐cell transplantation may be considered. Am. J. Hematol., 2011. © 2011 Wiley‐Liss, Inc.

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Early lymphopenia as a risk factor for chemotherapy‐induced febrile neutropenia

et al. 2003

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Febrile neutropenia (FN) is a frequent complication of cancer chemotherapy, which causes death in 4-21% of patients and worsens the quality of life of patients. As a simple and accurate way of identifying patients who are at risk of FN, a lymphocyte count on post-chemotherapy day 5 was suggested. To confirm the feasibility of this method and to define the incidence of FN among our own patient group, we conducted this prospective study. From September 2001 to February 2002, patients who received cytotoxic chemotherapy at Guro Hospital, Korea University, were enrolled. Blood sampling for a complete blood count was done on the starting day of chemotherapy and on day 3 and day 5 post-chemotherapy. The prospective results of the CBC were compared between the FN group and non-FN group. During the study period, 82 patients were enrolled. The male to female ratio was 52:30, and the median age was 56 years old (range: 14-78). Underlying malignancies were non-Hodgkin's lymphoma (14 patients), stomach cancer (17), breast cancer (11), NSCLC (7), hepatobiliary cancer (10), sarcoma (3), colorectal cancer (3), and others (17). The incidence of FN was 18% (15/82 patients), and ANC at the time of FN was 275 ± 327/µl. Duration of fever was 3.9 ± 3.5 days. The incidence of FN was significantly higher in patients with lymphocyte counts at day 3 ≤ 500/µl (P = 0.06), day 5 ≤ 500/µl (P = 0.023), day 3 ≤ 700/µl (P = 0.01), and day 5 ≤ 700/µl (P = 0.0001). As a result of a logistic regression test, a day-5 lymphocyte count ≤ 700/µl was identified as an independent risk factor for FN.In conclusion, a day-5 lymphocyte count <700/µl was a risk factor for FN. To strengthen our result, we are planning to validate in a larger patient group. Am.

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Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation in multiple myeloma or non-Hodgkin lymphoma

Cited by 260 publications

References 26 publications

The relationship between absolute lymphocyte count with PFS in patients with Hodgkin's lymphoma undergoing autologous hematopoietic cell transplant

The relationship between absolute lymphocyte count with PFS in patients with Hodgkin's lymphoma undergoing autologous hematopoietic cell transplant

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Early lymphopenia as a risk factor for chemotherapy‐induced febrile neutropenia

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