Clinical impact of absolute lymphocyte count on day 30 after unmanipulated haploidentical blood and marrow transplantation for pediatric patients with hematological malignancies.
Currently, limited information is available regarding the effects of early lymphocyte recovery on transplant outcomes in pediatric patients with hematological malignancies after unmanipulated haploidentical transplantation. In this study, we evaluated the association of Day 30 absolute lymphocyte count (ALC-30) with transplant outcomes in 60 consecutive pediatric patients with hematological malignancies receiving T-cell-repleted transplantation from an haploidentical related donors. After median follow-up of 36 months (range, 1.4-75 months), higher relapse rate was observed in patients with an ALC-30 < 300 cells/μL compared to patients with an ALC-30 ≥ 300 cells/μL (35.5% vs. 13.8%, P = 0.049). More patients died of infections in those with an ALC-30 < 300 cells/μL compared with patients with an ALC-30 ≥ 300 cells/μL (25.8% vs. 3.4%, P = 0.015). The ALC-30 above the cutoff value 300 cells/μL was associated with improved overall-survival (HR 0.301, 95% CI 0.117-0.771; P = 0.012), leukemia free survival (HR 0.195, 95% CI 0.078-0.498; P=0.002), less relapse (HR 0.224 95% CI 0.070-0.717; P = 0.012), and less transplant- related mortality (HR=0.166; 95%CI 0.037-0.750; P = 0.020). Our results suggest that a higher ALC-30 ≥ 300 cells/μL) could be a useful and simple tool to predict pediatric patients with a superior outcome after unmanipulated haploidentical transplantation.
Peking University People's hospital, Peking University Institute of Hematology, Beijing, China.
Ying-Jun
YJ
Chang
Xiang-Yu
XY
Zhao
Ming-Rui
MR
Huo
Lan-Ping
LP
Xu
Dai-Hong
DH
Liu
Kai-Yan
KY
Liu
Xiao-Jun
XJ
Huang
D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000276:immunology; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007519:Isoantigens / Q000276:immunology; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000166:cytology / Q000276:immunology*; D008297:Male; D009894:Opportunistic Infections / Q000453:epidemiology / Q000276:immunology; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D014184:Transplantation, Homologous
D007519:Isoantigens