Early lymphocyte recovery as a predictor of outcome, including relapse, after hematopoieticstem cell transplantation
Rev. bras. hematol. hemoter
; Rev. bras. hematol. hemoter;34(6): 430-435, 2012. ilus, tab
Article
in En
| LILACS
| ID: lil-662719
Responsible library:
BR408.1
ABSTRACT
BACKGROUND:
Despite advances in the treatment of acute leukemia, many patients need to undergo hematopoietic stem cell transplantation. Recent studies show that early lymphocyte recovery may be a predictor of relapse and survival in these patients.OBJECTIVE:
To analyze the influence of lymphocyte recovery on Days +30 and +100 post-transplant on the occurrence of relapse and survival.METHODS:
A descriptive, retrospective study was performed of 137 under 21-year-old patients who were submitted to hematopoietic stem cell transplantation for acute leukemia between 1995 and 2008. A lymphocyte count < 0.3 x 10(9)/L on Day +30 post-transplant was considered to be inadequate lymphocyte recovery and counts > 0.3 x 10(9)/L were considered adequate. Lymphocyte recovery was also analyzed on Day +100 with < 0.75 x 10(9)/Land < 0.75 x 10(9)/L being considered inadequate and adequate lymphocyte recovery, respectively.RESULTS:
There was no significant difference in the occurrence of relapse between patients with inadequate and adequate lymphocyte recovery on Day +30 post-transplant. However, the transplant-related mortality was significantly higher in patients with inadequate recovery on Day +30. Patients with inadequate lymphocyte recovery on Day +30 had worse overall survival and relapse-free survival than patients with adequate recovery. There was no significant difference in the occurrence of infections and acute or chronic graft-versus-host disease. Patients with inadequate lymphocyte recovery on Day +100 had worse overall survival and relapse-free survival and a higher cumulative incidence of relapse.CONCLUSION:
The evaluation of lymphocyte recovery on Day +30 is not a good predictor of relapse after transplant however patients with inadequate lymphocyte recovery had worse overall survival and relapse-free survival. Inadequate lymphocyte recovery on Day +100 is correlated with higher cumulative relapse as well as lower overall survival and relapse-free survival.Key words
Full text:
1
Index:
LILACS
Main subject:
Leukemia
/
Lymphocyte Count
/
Hematopoietic Stem Cell Transplantation
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
Rev. bras. hematol. hemoter
Journal subject:
HEMATOLOGIA
Year:
2012
Type:
Article