Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation in multiple myeloma or non-Hodgkin lymphoma

Luis F. Porrata, Morie Gertz, David J. Inwards, Mark R Litzow, Martha Lacy, Ayalew Tefferi, Dennis A. Gastineau, Angela Dispenzieri, Stephen Maxted Ansell, Ivana Micallef, Susan M. Geyer, Svetomir Nenad Markovic

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Autologous stem cell transplantation (ASCT) improves survival in patients with previously untreated multiple myeloma (MM) and relapsed, chemotherapy-sensitive, aggressive non-Hodgkin lymphoma (NHL). Lower relapse rates seen in allogeneic stem cell transplantation have been related to early absolute lymphocyte count (ALC) recovery as a manifestation of early graft-verus-tumor effect. In ASCT, the relation between ALC recovery and clinical outcomes in MM and NHL was not previously described. This is a retrospective study of patients with MM and NHL who underwent ASCT at the Mayo Clinic between 1987 and 1999. The ALC threshold was determined at 500 cells/μL on day 15 after ASCT. The study identified 126 patients with MM and 104 patients with NHL. The median overall survival (OS) and progression-free survival (PFS) times for patients with MM were significantly longer in patients with an ALC of 500 cells/μL or more than patients with an ALC of fewer than 500 cells/μL (33 vs 12 months, P < .0001; 16 vs 8 months, P < .0003, respectively). For patients with NHL, the median OS and PFS times were significantly longer in patients with an ALC of 500 cells/μL or more versus those with fewer than 500 cells/μL (not reached vs 6 months, P < .0001; not reached vs 4 months, P < .0001, respectively). Multivariate analysis demonstrated day 15 ALC to be an independent prognostic indicator for OS and PFS rates for both groups of patients. In conclusion, ALC is correlated with clinical outcome and requires further study.

Original languageEnglish (US)
Pages (from-to)579-585
Number of pages7
JournalBlood
Volume98
Issue number3
DOIs
StatePublished - Aug 1 2001

Fingerprint

Lymphocytes
Hematopoietic Stem Cell Transplantation
Stem cells
Multiple Myeloma
Non-Hodgkin's Lymphoma
Lymphocyte Count
Recovery
Survival
Stem Cell Transplantation
Disease-Free Survival
Chemotherapy
Grafts
Tumors
Multivariate Analysis
Survival Rate
Retrospective Studies
Transplants
Recurrence
Drug Therapy

ASJC Scopus subject areas

  • Hematology

Cite this

@article{45377d7f7c7e41d1a63efe20f516117f,
title = "Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation in multiple myeloma or non-Hodgkin lymphoma",
abstract = "Autologous stem cell transplantation (ASCT) improves survival in patients with previously untreated multiple myeloma (MM) and relapsed, chemotherapy-sensitive, aggressive non-Hodgkin lymphoma (NHL). Lower relapse rates seen in allogeneic stem cell transplantation have been related to early absolute lymphocyte count (ALC) recovery as a manifestation of early graft-verus-tumor effect. In ASCT, the relation between ALC recovery and clinical outcomes in MM and NHL was not previously described. This is a retrospective study of patients with MM and NHL who underwent ASCT at the Mayo Clinic between 1987 and 1999. The ALC threshold was determined at 500 cells/μL on day 15 after ASCT. The study identified 126 patients with MM and 104 patients with NHL. The median overall survival (OS) and progression-free survival (PFS) times for patients with MM were significantly longer in patients with an ALC of 500 cells/μL or more than patients with an ALC of fewer than 500 cells/μL (33 vs 12 months, P < .0001; 16 vs 8 months, P < .0003, respectively). For patients with NHL, the median OS and PFS times were significantly longer in patients with an ALC of 500 cells/μL or more versus those with fewer than 500 cells/μL (not reached vs 6 months, P < .0001; not reached vs 4 months, P < .0001, respectively). Multivariate analysis demonstrated day 15 ALC to be an independent prognostic indicator for OS and PFS rates for both groups of patients. In conclusion, ALC is correlated with clinical outcome and requires further study.",
author = "Porrata, {Luis F.} and Morie Gertz and Inwards, {David J.} and Litzow, {Mark R} and Martha Lacy and Ayalew Tefferi and Gastineau, {Dennis A.} and Angela Dispenzieri and Ansell, {Stephen Maxted} and Ivana Micallef and Geyer, {Susan M.} and Markovic, {Svetomir Nenad}",
year = "2001",
month = "8",
day = "1",
doi = "10.1182/blood.V98.3.579",
language = "English (US)",
volume = "98",
pages = "579--585",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "3",

}

TY - JOUR

T1 - Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation in multiple myeloma or non-Hodgkin lymphoma

AU - Porrata, Luis F.

AU - Gertz, Morie

AU - Inwards, David J.

AU - Litzow, Mark R

AU - Lacy, Martha

AU - Tefferi, Ayalew

AU - Gastineau, Dennis A.

AU - Dispenzieri, Angela

AU - Ansell, Stephen Maxted

AU - Micallef, Ivana

AU - Geyer, Susan M.

AU - Markovic, Svetomir Nenad

PY - 2001/8/1

Y1 - 2001/8/1

N2 - Autologous stem cell transplantation (ASCT) improves survival in patients with previously untreated multiple myeloma (MM) and relapsed, chemotherapy-sensitive, aggressive non-Hodgkin lymphoma (NHL). Lower relapse rates seen in allogeneic stem cell transplantation have been related to early absolute lymphocyte count (ALC) recovery as a manifestation of early graft-verus-tumor effect. In ASCT, the relation between ALC recovery and clinical outcomes in MM and NHL was not previously described. This is a retrospective study of patients with MM and NHL who underwent ASCT at the Mayo Clinic between 1987 and 1999. The ALC threshold was determined at 500 cells/μL on day 15 after ASCT. The study identified 126 patients with MM and 104 patients with NHL. The median overall survival (OS) and progression-free survival (PFS) times for patients with MM were significantly longer in patients with an ALC of 500 cells/μL or more than patients with an ALC of fewer than 500 cells/μL (33 vs 12 months, P < .0001; 16 vs 8 months, P < .0003, respectively). For patients with NHL, the median OS and PFS times were significantly longer in patients with an ALC of 500 cells/μL or more versus those with fewer than 500 cells/μL (not reached vs 6 months, P < .0001; not reached vs 4 months, P < .0001, respectively). Multivariate analysis demonstrated day 15 ALC to be an independent prognostic indicator for OS and PFS rates for both groups of patients. In conclusion, ALC is correlated with clinical outcome and requires further study.

AB - Autologous stem cell transplantation (ASCT) improves survival in patients with previously untreated multiple myeloma (MM) and relapsed, chemotherapy-sensitive, aggressive non-Hodgkin lymphoma (NHL). Lower relapse rates seen in allogeneic stem cell transplantation have been related to early absolute lymphocyte count (ALC) recovery as a manifestation of early graft-verus-tumor effect. In ASCT, the relation between ALC recovery and clinical outcomes in MM and NHL was not previously described. This is a retrospective study of patients with MM and NHL who underwent ASCT at the Mayo Clinic between 1987 and 1999. The ALC threshold was determined at 500 cells/μL on day 15 after ASCT. The study identified 126 patients with MM and 104 patients with NHL. The median overall survival (OS) and progression-free survival (PFS) times for patients with MM were significantly longer in patients with an ALC of 500 cells/μL or more than patients with an ALC of fewer than 500 cells/μL (33 vs 12 months, P < .0001; 16 vs 8 months, P < .0003, respectively). For patients with NHL, the median OS and PFS times were significantly longer in patients with an ALC of 500 cells/μL or more versus those with fewer than 500 cells/μL (not reached vs 6 months, P < .0001; not reached vs 4 months, P < .0001, respectively). Multivariate analysis demonstrated day 15 ALC to be an independent prognostic indicator for OS and PFS rates for both groups of patients. In conclusion, ALC is correlated with clinical outcome and requires further study.

UR - http://www.scopus.com/inward/record.url?scp=0035437134&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035437134&partnerID=8YFLogxK

U2 - 10.1182/blood.V98.3.579

DO - 10.1182/blood.V98.3.579

M3 - Article

VL - 98

SP - 579

EP - 585

JO - Blood

JF - Blood

SN - 0006-4971

IS - 3

ER -