Early lymphocyte recovery after autologous stem cell transplantation predicts superior survival in mantle-cell lymphoma.
Autologous stem cell transplantation (ASCT) is an effective treatment strategy for mantle-cell lymphoma (MCL) demonstrating significantly prolonged progression-free survival (PFS) when compared to interferon-alpha maintenance therapy of patients in first remission. The study of absolute lymphocyte count at day 15 (ALC-15) after ASCT as a prognostic factor in non-Hodgkin lymphoma (NHL) included different lymphoma subtypes. The relationship of ALC-15 after ASCT in MCL has not been specifically addressed. We evaluated the impact of ALC-15 recovery on survival of MCL patients undergoing ASCT. We studied 42 consecutive MCL patients who underwent ASCT at the Mayo Clinic in Rochester from 1993 to 2005. ALC-15 threshold was set at 500 cells/microl. The median follow-up after ASCT was 25 months (range, 2-106 months). The median overall survival (OS) and PFS times were significantly better for the 24 patients who achieved an ALC-15 >or=500 cells/microl compared with 18 patients with ALC-15 <500 cells/microl (not reached vs 30 months, P<0.01 and not reached vs 16 months, P<0.0006, respectively). Multivariate analysis demonstrated ALC-15 to be an independent prognostic factor for OS and PFS. The ALC-15 >or=500 cells/microl is associated with a significantly improved clinical outcome following ASCT in MCL.
Joao
C
C
Hematology Department, Portuguese Institute of Oncology, Lisbon, Portugal.
Porrata
L F
LF
Inwards
D J
DJ
Ansell
S M
SM
Micallef
I N
IN
Johnston
P B
PB
Gastineau
D A
DA
Markovic
S N
SN
D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008212:Lymphocyte Depletion; D020522:Lymphoma, Mantle-Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous