title: The effect of absolute lymphocyte count recovery kinetics on survival after autologous stem cell transplantation for non-Hodgkin's lymphoma.
abstract: Absolute lymphocyte count (ALC) >or=500 cells/microl at day 15 after autologous stem cell transplantation (ASCT) is a powerful independent, prognostic indicator for survival in multiple hematological malignancies. A limitation in these studies was the selection of a single time point (day 15 post-ASCT) as the only discriminator of clinical outcome in relation to ALC recovery. We hypothesized there is a continuous and not discrete relationship between ALC recovery and clinical outcome post-ASCT in NHL. Therefore, we analyzed 274 consecutive patients who underwent ASCT for NHL between 1987 and 2001. The primary end point was to assess the impact of the kinetics of post-ASCT lymphocyte recovery>or=500 cells/microl (K-ALC) on overall survival (OS) and progression-free survival (PFS). K-ALC was a predictor of OS and PFS when the Cox proportional hazards model was used with K-ALC entered as a continuous variable (p<0.0001). Multivariate analysis demonstrated K-ALC recovery post-ASCT to be an independent prognostic indicator for OS and PFS. These data support our hypothesis that the K-ALC post-ASCT is associated with clinical outcome in NHL.
authors.affiliation: Division of Hematology, Department of Internal Medecine, Mayo Clinic, Rochester, MN 55909, USA.
authors.forename: Yinlee
authors.initials: Y
authors.lastname: Yoong
authors.forename: Luis F
authors.initials: LF
authors.lastname: Porrata
authors.forename: David J
authors.initials: DJ
authors.lastname: Inwards
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Ansell
authors.forename: Ivana N M
authors.initials: IN
authors.lastname: Micallef
authors.forename: Mark R
authors.initials: MR
authors.lastname: Litzow
authors.forename: Morie A
authors.initials: MA
authors.lastname: Gertz
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Gastineau
authors.forename: Ayalew
authors.initials: A
authors.lastname: Tefferi
authors.forename: Michelle
authors.initials: M
authors.lastname: Elliott
authors.forename: Denis S
authors.initials: DS
authors.lastname: Snow
authors.forename: Willian J
authors.initials: WJ
authors.lastname: Hogan
authors.forename: Svetomir N
authors.initials: SN
authors.lastname: Markovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007700:Kinetics; D018655:Lymphocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous