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ISSN 0864-0289 (Print)

2014, Number 3

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Rev Cubana Hematol Inmunol Hemoter 2014; 30 (3)

Early lymphocyte recovery as a prognostic factor after hematopoietic stem cell transplantation

Jaime FJC, Romero GA, Anoceto MA, Arencibia NAA

Language: Spanish
References: 27
Page: 223-232
PDF size: 217.36 Kb.


ABSTRACT

Introduction: Early lymphocyte recovery is a prognostic factor related to a higher event-free survival and overall survival in patients who have received hematopoietic transplantation.
Objective: To determine the prognostic value of absolute lymphocyte count (ALC).
Method: A study in pediatric patients with hematological malignancies transplanted at the Institute of Hematology and Immunology from 1986 to 2011 was performed. The study group included 36 patients: 15 with acute lymphoid leukemia, 13 with acute myeloid leukemia, 6 with chronic myeloid leukemia and 2 with non Hodgkin lymphoma. Twenty transplants were autologous and 13 allogeneic. As stem cell source, bone marrow was used in 22 patients and peripheral blood in 14.
Results: 60.9 % of the autologous transplants reached an absolute lymphocyte count ≥ 500 × mm3 on day 15 (ALC-15), whereas in the allogeneic this was achieved in 53.8 %. Peripheral blood had a higher ALC-15 than bone marrow, 78.6 % and 45.4 %, respectively (p= 0.049). Prognostic factors associated to worse overall survival were sepsis (p ‹ 0.001), ALC-15 ‹ 500 × mm3 (p= 0.001) and relapse (p = 0.03). Kapplan-Meier curves showed better overall survival and event-free survival after five years in patients with ALC-15 ≥ 500 × mm3 (85 % vs 15 %, p ‹ 0.001).
Conclusions: The ALC-15 ≥ 500 × mm3 is a simple and useful tool to predict a better outcome in pediatric patients undergoing hematopoietic transplantation.


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