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; M. A. Gertz; S. M. Geyer; M. R. Litzow; D. A. Gastineau; S. B. Moore; A. A. Pineda; K. L. Bundy; D. J. Padley; D. Persky; M. Q. Lacy; A. Dispenzieri; D. S. Snow; S. N. Markovic

doi:10.1038/sj.leu.2403341

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, M. A. Gertz, S. M. Geyer, M. R. Litzow, D. A. Gastineau, S. B. Moore, A. A. Pineda, K. L. Bundy, D. J. Padley, D. Persky, M. Q. Lacy, A. Dispenzieri, D. S. Snow, S. N. Markovic

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74 Scopus citations

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 (r_s=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 language	English (US)
Pages (from-to)	1085-1092
Number of pages	8
Journal	Leukemia
Volume	18
Issue number	6
DOIs	https://doi.org/10.1038/sj.leu.2403341
State	Published - Jun 2004

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
Oncology
Cancer Research

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10.1038/sj.leu.2403341

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Porrata, L. F., Gertz, M. A., Geyer, S. M., Litzow, M. R., Gastineau, D. A., Moore, S. B., Pineda, A. A., Bundy, K. L., Padley, D. J., Persky, D., Lacy, M. Q., Dispenzieri, A., Snow, D. S., & Markovic, S. N. (2004). The dose of infused lymphocytes in the autograft directly correlates with clinical outcome after autologous peripheral blood hematopoietic stem cell transplantation in multiple myeloma. Leukemia, 18(6), 1085-1092. https://doi.org/10.1038/sj.leu.2403341

Porrata, LF, Gertz, MA , Geyer, SM , Litzow, MR, Gastineau, DA, Moore, SB, Pineda, AA, Bundy, KL, Padley, DJ, Persky, D, Lacy, MQ , Dispenzieri, A, Snow, DS & Markovic, SN 2004, 'The dose of infused lymphocytes in the autograft directly correlates with clinical outcome after autologous peripheral blood hematopoietic stem cell transplantation in multiple myeloma', Leukemia, vol. 18, no. 6, pp. 1085-1092. https://doi.org/10.1038/sj.leu.2403341

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

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.",

keywords = "Absolute lymphocyte recovery, Autologous peripheral blood hematopoietic stem cell transplantation, Infused peripheral blood autograft absolute lymphocyte count, Multiple myeloma",

author = "Porrata, {Luis F.} and Gertz, {M. A.} and Geyer, {S. M.} and Litzow, {M. R.} and Gastineau, {D. A.} and Moore, {S. B.} and Pineda, {A. A.} and Bundy, {K. L.} and Padley, {D. J.} and D. Persky and Lacy, {M. Q.} and A. Dispenzieri and Snow, {D. S.} and Markovic, {S. N.}",

year = "2004",

month = jun,

doi = "10.1038/sj.leu.2403341",

language = "English (US)",

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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, M. A.

AU - Geyer, S. M.

AU - Litzow, M. 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, M. Q.

AU - Dispenzieri, A.

AU - Snow, D. S.

AU - Markovic, S. N.

PY - 2004/6

Y1 - 2004/6

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.

KW - Absolute lymphocyte recovery

KW - Autologous peripheral blood hematopoietic stem cell transplantation

KW - Infused peripheral blood autograft absolute lymphocyte count

KW - Multiple myeloma

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

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