CD4+ T lymphocyte counts after autologous transplantation in multiple myeloma: a retrospective study.
The risk for opportunistic infections is correlated with low CD4+ T lymphocyte counts in patients with HIV. We performed a retrospective analysis in 54 patients with multiple myeloma undergoing high-dose melphalan chemotherapy + autologous peripheral blood stem cell transplantation to better define the value of routine control of CD4+ T lymphocyte counts in this important patient group. In 61% of our patients, CD4+ T lymphocyte counts after recovery from neutropenia were <200/microl and <100/microl in 24% (median = 181/microl). Overall survival, progression-free survival, response to antineoplastic therapy and frequency of post-transplant infections were not significantly different when patients with CD4+ T lymphocyte counts <200/microl and >200/microl were compared. However, overall survival was significantly shorter in the subgroup of 13 patients with very low CD4+ T lymphocyte counts (<100/microl) (P = 0.036). In 79.6% of all patients, at least one infection NCI-CTC grade II - IV developed within 100 days post-transplant. Opportunistic infections were rare. This analysis suggests that patients with CD4+ T lymphocyte counts < 100/microl may have a poorer prognosis.
Gorschlüter
Marcus
M
Department of Internal Medicine I, University of Bonn, Bonn, Germany. gorschlueter@uni-bonn.de
Glasmacher
Axel
A
Sarazin
Susann
S
Hackbarth
Frank
F
Hoebert
Eckfried
E
Orlopp
Katjana
K
Schmidt-Wolf
Ingo G H
IG
Mey
Ulrich
U
D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D015415:Biomarkers / Q000032:analysis*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014182:Transplantation, Autologous
D018906:Antineoplastic Agents, Alkylating; D015415:Biomarkers; D008558:Melphalan