New-Onset Lymphopenia Assessed during Routine Follow-up Is a Risk Factor for Relapse Postautologous Peripheral Blood Hematopoietic Stem Cell Transplantation in Patients with Diffuse Large B-Cell Lymphoma

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Abstract

A specific predictor during routine follow-up to ascertain risk for postautologous peripheral blood hematopoietic stem cell transplantation (post-APHSCT) relapse in non-Hodgkin lymphoma (NHL) has not been identified. Thus, we studied if new-onset lymphopenia measured by the absolute lymphocyte count (ALC) was a marker of post-APHSCT NHL relapse. ALC was obtained at the time of confirmed relapse, and at last follow-up with no relapse. From 1993 until 2005, 269 patients treated with APHSCT for diffuse large B-cell lymphoma (DLBCL) were included in this study. Patients at last follow-up without relapse (N = 137) had a higher ALC compared with those with low ALC at the time of confirmed relapsed (N = 132) (median ALC ×109/L of 1.66 versus 0.71, P < .0001, respectively). ALC at follow-up was a strong predictor for relapse with an area under the curve (AUC) = 0.86 (P < .0001). An ALC <1.0 × 109/L at the time of confirmed relapse had a positive predictive value of 89% and a positive likelihood ratio of 8.4 to predict relapse post-APHSCT. Patients with an ALC ≥1.0 × 109/L (N = 147) had a cumulative incidence of relapse of 19% versus 92%, with an ALC <1.0 × 109/L (N = 122) (P < .0001). This study suggests that new-onset lymphopenia measured by ALC can be used as marker to assess risk of DLBCL relapse during routine follow-up for after APHSCT.

Original languageEnglish (US)
Pages (from-to)376-383
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume16
Issue number3
DOIs
StatePublished - Mar 2010

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Peripheral Blood Stem Cell Transplantation
Lymphopenia
Lymphoma, Large B-Cell, Diffuse
Hematopoietic Stem Cell Transplantation
Lymphocyte Count
Recurrence
Non-Hodgkin's Lymphoma
Area Under Curve

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

@article{53ee63570fbf43dea3183a4042896030,
title = "New-Onset Lymphopenia Assessed during Routine Follow-up Is a Risk Factor for Relapse Postautologous Peripheral Blood Hematopoietic Stem Cell Transplantation in Patients with Diffuse Large B-Cell Lymphoma",
abstract = "A specific predictor during routine follow-up to ascertain risk for postautologous peripheral blood hematopoietic stem cell transplantation (post-APHSCT) relapse in non-Hodgkin lymphoma (NHL) has not been identified. Thus, we studied if new-onset lymphopenia measured by the absolute lymphocyte count (ALC) was a marker of post-APHSCT NHL relapse. ALC was obtained at the time of confirmed relapse, and at last follow-up with no relapse. From 1993 until 2005, 269 patients treated with APHSCT for diffuse large B-cell lymphoma (DLBCL) were included in this study. Patients at last follow-up without relapse (N = 137) had a higher ALC compared with those with low ALC at the time of confirmed relapsed (N = 132) (median ALC ×109/L of 1.66 versus 0.71, P < .0001, respectively). ALC at follow-up was a strong predictor for relapse with an area under the curve (AUC) = 0.86 (P < .0001). An ALC <1.0 × 109/L at the time of confirmed relapse had a positive predictive value of 89{\%} and a positive likelihood ratio of 8.4 to predict relapse post-APHSCT. Patients with an ALC ≥1.0 × 109/L (N = 147) had a cumulative incidence of relapse of 19{\%} versus 92{\%}, with an ALC <1.0 × 109/L (N = 122) (P < .0001). This study suggests that new-onset lymphopenia measured by ALC can be used as marker to assess risk of DLBCL relapse during routine follow-up for after APHSCT.",
author = "Porrata, {Luis F.} and Inwards, {David J.} and Ansell, {Stephen Maxted} and Ivana Micallef and Johnston, {Patrick Bruce} and William Hogan and Markovic, {Svetomir Nenad}",
year = "2010",
month = "3",
doi = "10.1016/j.bbmt.2009.10.029",
language = "English (US)",
volume = "16",
pages = "376--383",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
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T1 - New-Onset Lymphopenia Assessed during Routine Follow-up Is a Risk Factor for Relapse Postautologous Peripheral Blood Hematopoietic Stem Cell Transplantation in Patients with Diffuse Large B-Cell Lymphoma

AU - Porrata, Luis F.

AU - Inwards, David J.

AU - Ansell, Stephen Maxted

AU - Micallef, Ivana

AU - Johnston, Patrick Bruce

AU - Hogan, William

AU - Markovic, Svetomir Nenad

PY - 2010/3

Y1 - 2010/3

N2 - A specific predictor during routine follow-up to ascertain risk for postautologous peripheral blood hematopoietic stem cell transplantation (post-APHSCT) relapse in non-Hodgkin lymphoma (NHL) has not been identified. Thus, we studied if new-onset lymphopenia measured by the absolute lymphocyte count (ALC) was a marker of post-APHSCT NHL relapse. ALC was obtained at the time of confirmed relapse, and at last follow-up with no relapse. From 1993 until 2005, 269 patients treated with APHSCT for diffuse large B-cell lymphoma (DLBCL) were included in this study. Patients at last follow-up without relapse (N = 137) had a higher ALC compared with those with low ALC at the time of confirmed relapsed (N = 132) (median ALC ×109/L of 1.66 versus 0.71, P < .0001, respectively). ALC at follow-up was a strong predictor for relapse with an area under the curve (AUC) = 0.86 (P < .0001). An ALC <1.0 × 109/L at the time of confirmed relapse had a positive predictive value of 89% and a positive likelihood ratio of 8.4 to predict relapse post-APHSCT. Patients with an ALC ≥1.0 × 109/L (N = 147) had a cumulative incidence of relapse of 19% versus 92%, with an ALC <1.0 × 109/L (N = 122) (P < .0001). This study suggests that new-onset lymphopenia measured by ALC can be used as marker to assess risk of DLBCL relapse during routine follow-up for after APHSCT.

AB - A specific predictor during routine follow-up to ascertain risk for postautologous peripheral blood hematopoietic stem cell transplantation (post-APHSCT) relapse in non-Hodgkin lymphoma (NHL) has not been identified. Thus, we studied if new-onset lymphopenia measured by the absolute lymphocyte count (ALC) was a marker of post-APHSCT NHL relapse. ALC was obtained at the time of confirmed relapse, and at last follow-up with no relapse. From 1993 until 2005, 269 patients treated with APHSCT for diffuse large B-cell lymphoma (DLBCL) were included in this study. Patients at last follow-up without relapse (N = 137) had a higher ALC compared with those with low ALC at the time of confirmed relapsed (N = 132) (median ALC ×109/L of 1.66 versus 0.71, P < .0001, respectively). ALC at follow-up was a strong predictor for relapse with an area under the curve (AUC) = 0.86 (P < .0001). An ALC <1.0 × 109/L at the time of confirmed relapse had a positive predictive value of 89% and a positive likelihood ratio of 8.4 to predict relapse post-APHSCT. Patients with an ALC ≥1.0 × 109/L (N = 147) had a cumulative incidence of relapse of 19% versus 92%, with an ALC <1.0 × 109/L (N = 122) (P < .0001). This study suggests that new-onset lymphopenia measured by ALC can be used as marker to assess risk of DLBCL relapse during routine follow-up for after APHSCT.

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SP - 376

EP - 383

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

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