The dose of infused lymphocytes in the autograft directly correlates with clinical outcome after autologous peripheral blood hematopoietic stem cell transplantation in multiple myeloma

Luis F. Porrata, Morie Gertz, S. M. Geyer, Mark R Litzow, D. A. Gastineau, S. B. Moore, A. A. Pineda, K. L. Bundy, D. J. Padley, D. Persky, Martha Lacy, Angela Dispenzieri, D. S. Snow, Svetomir Nenad Markovic

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Absolute lymphocyte count at day 15 (ALC-15) after autologous peripheral blood hematopoietic stem cell transplantation (APHSCT) is an independent prognostic factor for survival in multiple myeloma (MM); however, factors affecting ALC-15 in MM remain unknown. We hypothesized that the dose of infused peripheral blood autograft lymphocytes (autograft absolute lymphocyte count: A-ALC) impacts ALC-15 recovery. Between 1989 and 2001, 267 consecutive MM patients underwent APHSCT. We set out to determine the correlation between A-ALC and ALC-15 and the utility of A-ALC as a marker for ALC-15 recovery. A-ALC was found to be both a strong predictor for area under curve (AUC=0.93; P=0.0001) and strongly correlated with (rs=0.83; P=0.0001) ALC-15 recovery. Higher infused A-ALC was significantly correlated with an ALC-15≥ 500/μl. In addition, median post-transplant overall survival (OS) and time to progression (TTP) were longer in patients who received an A-ALC ≥0.5 × 109 lymphocytes/kg, versus A-ALC <0.5 × 109 lymphocytes/kg (58 vs 30 months, P= 0.00022; 22 vs 15 months, P<0.00012, respectively). Multivariate analysis demonstrated A-ALC as an independent prognostic indicator for OS and TTP. These results indicate that an infused dose of autograft lymphocytes significantly impacts clinical outcome post-APHSCT in MM.

Original languageEnglish (US)
Pages (from-to)1085-1092
Number of pages8
JournalLeukemia
Volume18
Issue number6
DOIs
StatePublished - Jun 2004

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Peripheral Blood Stem Cell Transplantation
Hematopoietic Stem Cell Transplantation
Autografts
Lymphocyte Count
Multiple Myeloma
Lymphocytes
Area Under Curve
Survival
Multivariate Analysis
Transplants

Keywords

  • Absolute lymphocyte recovery
  • Autologous peripheral blood hematopoietic stem cell transplantation
  • Infused peripheral blood autograft absolute lymphocyte count
  • Multiple myeloma

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

Cite this

The dose of infused lymphocytes in the autograft directly correlates with clinical outcome after autologous peripheral blood hematopoietic stem cell transplantation in multiple myeloma. / Porrata, Luis F.; Gertz, Morie; Geyer, S. M.; Litzow, Mark R; Gastineau, D. A.; Moore, S. B.; Pineda, A. A.; Bundy, K. L.; Padley, D. J.; Persky, D.; Lacy, Martha; Dispenzieri, Angela; Snow, D. S.; Markovic, Svetomir Nenad.

In: Leukemia, Vol. 18, No. 6, 06.2004, p. 1085-1092.

Research output: Contribution to journalArticle

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abstract = "Absolute lymphocyte count at day 15 (ALC-15) after autologous peripheral blood hematopoietic stem cell transplantation (APHSCT) is an independent prognostic factor for survival in multiple myeloma (MM); however, factors affecting ALC-15 in MM remain unknown. We hypothesized that the dose of infused peripheral blood autograft lymphocytes (autograft absolute lymphocyte count: A-ALC) impacts ALC-15 recovery. Between 1989 and 2001, 267 consecutive MM patients underwent APHSCT. We set out to determine the correlation between A-ALC and ALC-15 and the utility of A-ALC as a marker for ALC-15 recovery. A-ALC was found to be both a strong predictor for area under curve (AUC=0.93; P=0.0001) and strongly correlated with (rs=0.83; P=0.0001) ALC-15 recovery. Higher infused A-ALC was significantly correlated with an ALC-15≥ 500/μl. In addition, median post-transplant overall survival (OS) and time to progression (TTP) were longer in patients who received an A-ALC ≥0.5 × 109 lymphocytes/kg, versus A-ALC <0.5 × 109 lymphocytes/kg (58 vs 30 months, P= 0.00022; 22 vs 15 months, P<0.00012, respectively). Multivariate analysis demonstrated A-ALC as an independent prognostic indicator for OS and TTP. These results indicate that an infused dose of autograft lymphocytes significantly impacts clinical outcome post-APHSCT in MM.",
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T1 - The dose of infused lymphocytes in the autograft directly correlates with clinical outcome after autologous peripheral blood hematopoietic stem cell transplantation in multiple myeloma

AU - Porrata, Luis F.

AU - Gertz, Morie

AU - Geyer, S. M.

AU - Litzow, Mark R

AU - Gastineau, D. A.

AU - Moore, S. B.

AU - Pineda, A. A.

AU - Bundy, K. L.

AU - Padley, D. J.

AU - Persky, D.

AU - Lacy, Martha

AU - Dispenzieri, Angela

AU - Snow, D. S.

AU - Markovic, Svetomir Nenad

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N2 - Absolute lymphocyte count at day 15 (ALC-15) after autologous peripheral blood hematopoietic stem cell transplantation (APHSCT) is an independent prognostic factor for survival in multiple myeloma (MM); however, factors affecting ALC-15 in MM remain unknown. We hypothesized that the dose of infused peripheral blood autograft lymphocytes (autograft absolute lymphocyte count: A-ALC) impacts ALC-15 recovery. Between 1989 and 2001, 267 consecutive MM patients underwent APHSCT. We set out to determine the correlation between A-ALC and ALC-15 and the utility of A-ALC as a marker for ALC-15 recovery. A-ALC was found to be both a strong predictor for area under curve (AUC=0.93; P=0.0001) and strongly correlated with (rs=0.83; P=0.0001) ALC-15 recovery. Higher infused A-ALC was significantly correlated with an ALC-15≥ 500/μl. In addition, median post-transplant overall survival (OS) and time to progression (TTP) were longer in patients who received an A-ALC ≥0.5 × 109 lymphocytes/kg, versus A-ALC <0.5 × 109 lymphocytes/kg (58 vs 30 months, P= 0.00022; 22 vs 15 months, P<0.00012, respectively). Multivariate analysis demonstrated A-ALC as an independent prognostic indicator for OS and TTP. These results indicate that an infused dose of autograft lymphocytes significantly impacts clinical outcome post-APHSCT in MM.

AB - Absolute lymphocyte count at day 15 (ALC-15) after autologous peripheral blood hematopoietic stem cell transplantation (APHSCT) is an independent prognostic factor for survival in multiple myeloma (MM); however, factors affecting ALC-15 in MM remain unknown. We hypothesized that the dose of infused peripheral blood autograft lymphocytes (autograft absolute lymphocyte count: A-ALC) impacts ALC-15 recovery. Between 1989 and 2001, 267 consecutive MM patients underwent APHSCT. We set out to determine the correlation between A-ALC and ALC-15 and the utility of A-ALC as a marker for ALC-15 recovery. A-ALC was found to be both a strong predictor for area under curve (AUC=0.93; P=0.0001) and strongly correlated with (rs=0.83; P=0.0001) ALC-15 recovery. Higher infused A-ALC was significantly correlated with an ALC-15≥ 500/μl. In addition, median post-transplant overall survival (OS) and time to progression (TTP) were longer in patients who received an A-ALC ≥0.5 × 109 lymphocytes/kg, versus A-ALC <0.5 × 109 lymphocytes/kg (58 vs 30 months, P= 0.00022; 22 vs 15 months, P<0.00012, respectively). Multivariate analysis demonstrated A-ALC as an independent prognostic indicator for OS and TTP. These results indicate that an infused dose of autograft lymphocytes significantly impacts clinical outcome post-APHSCT in MM.

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