title: Leukemia burden delays lymphocyte and platelet recovery after allo-SCT for AML.
abstract: Lymphocyte and platelet recovery may influence outcomes of allo-SCT for treatment of AML. It is not clear, however, if this impact is independent of patient and transplant characteristics. To investigate this question, we evaluated the influence of pre- or post transplant factors on day +30 absolute lymphocyte count (ALC) and the speed of platelet engraftment. We studied 106 AML patients treated with fludarabine and melphalan reduced-intensity conditioning and allo-SCT. Twenty nine percent of patients were in CR at the initiation of the conditioning, 39% had active disease with circulating blasts and 32% had active disease without circulating blasts. The graft source was peripheral blood from a matched sibling donor in 55% and BM from a matched unrelated donor in 45%. Our data showed that the presence of circulating blasts before transplantation is significantly correlated with low post-SCT day +30 ALC and slow platelet engraftment. This finding suggests that the impact of early ALC and platelet recovery on transplant outcome may not be independent of disease status at transplantation.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Saliba
authors.forename: K V
authors.initials: KV
authors.lastname: Komanduri
authors.forename: S
authors.initials: S
authors.lastname: Giralt
authors.forename: J
authors.initials: J
authors.lastname: de Souza
authors.forename: P
authors.initials: P
authors.lastname: Patah
authors.forename: B
authors.initials: B
authors.lastname: Oran
authors.forename: D
authors.initials: D
authors.lastname: Couriel
authors.forename: G
authors.initials: G
authors.lastname: Rondon
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
authors.forename: M
authors.initials: M
authors.lastname: de Lima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001792:Blood Platelets / Q000502:physiology; D005260:Female; D006085:Graft Survival; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007700:Kinetics; D015470:Leukemia, Myeloid, Acute / Q000473:pathology* / Q000628:therapy*; D008214:Lymphocytes / Q000502:physiology; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D047368:Tumor Burden; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D014740:Vidarabine; C024352:fludarabine; D008558:Melphalan