title: Influence of lymphocyte recovery on outcome of haploidentical transplantation for hematologic malignancies.
abstract: Unmanipulated human leukocyte antigen (HLA)-mismatched/haploidentical blood and marrow transplantation is an established treatment for patients without HLA-matched related or unrelated donors. However, the prognostic significance of early lymphocyte recovery in this transplant setting is not defined. In this study, we investigated the association of day 30 absolute lymphocyte count (ALC-30) with outcome after unmanipulated HLA-mismatched/haploidentical transplantation. We prospectively analyzed the relationship between ALC-30 and transplant outcomes in 206 patients with hematologic malignancies receiving T-cell-replete transplantation from HLA-mismatched/haploidentical related donors. Multivariate analysis showed that ALC-30 above the cutoff value of 300 cells/microL was associated with improved overall survival (hazard ratio [HR], 0.258; 95% confidence interval [CI], 0.141-0.472; p < 0.0001); improved cancer-free survival (HR, 0.289; 95% CI, 0.166-0.501; p < 0.0001); reduced relapse (HR, 0.370; 95% CI, 0.161-0.853; p = 0.020); and decreased transplant-related mortality (HR, 0.211; 95% CI, 0.097-0.457; p < 0.0001). Our results suggest that the recovery of ALC-30 might have an influence on transplant outcomes following unmanipulated HLA-mismatched/haploidentical transplantation.
authors.affiliation: From Peking University People's Hospital (YJC, XYZ, MRH, LPX, DHL, KYL, XJH), Peking University Institute of Hematology, Beijing; and Department of Hematology (YJC), Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Ying-Jun
authors.initials: YJ
authors.lastname: Chang
authors.forename: Xiang-Yu
authors.initials: XY
authors.lastname: Zhao
authors.forename: Ming-Rui
authors.initials: MR
authors.lastname: Huo
authors.forename: Lan-Ping
authors.initials: LP
authors.lastname: Xu
authors.forename: Dai-Hong
authors.initials: DH
authors.lastname: Liu
authors.forename: Kai-Yan
authors.initials: KY
authors.lastname: Liu
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006680:HLA Antigens / Q000276:immunology; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000276:immunology* / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018655:Lymphocyte Count; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008727:Methotrexate