Absolute lymphocyte count (ALC) ≥1000 cells/mm3 on day +23 was an independent predictor of prolonged survival in patients with T/NK-cell lymphoma after autologous peripheral blood stem cell transplantation (APBSCT). To understand the prognostic value of lymphocyte recovery, we performed a retrospective study analyzing the result of 59 patients with multiple myeloma (MM) patients who underwent APBSCT. All patients were in complete or partial response after APBSCT. A median age at APBSCT was 51. Peripheral blood stem cells were mobilized and collected after cytoxan and G-CSF. The conditioning regimen was melphalan 200. ALC recovery day was defined as a first day of 3 consecutive days when ALC has been recovered more than 1000/mm3. A median value was used for the analysis of each noncategorical variable. A median follow-up time after APBSCT was 33.8 months and median recovery days of ALC ≥1000 cells/mm3 was 23 days. Prognostic factors at the time of APBSCT for transplant OS and PFS included beta-2 microglobulin, serum albumin, recovery days of neutrophil ≥500/mm3, infused mononuclear cell dose, infused CD+34 cell dose and recovery days of ALC ≥1000 cells/mm3. Univariate analysis revealed that significant variables at APBSCT for overall survival (OS) were beta-2 microglobulin, day of neutrophil engraftment and recovery days of ALC. Positive predictors at APBSCT for progression-free survival (PFS) were beta-2 microglobulin, day of neutrophil engraftment, serum albumin, infused mononuclear cell count, infused CD +34 cell count and recovery days of ALC. ALC ≥1000 cells/μL on day +23 was an independent predictive prognostic factors for better PFS (P = 0.003; Relative risk (RR) = 3.710; 95% Confidence interval (CI), 1.576–8.736) and showed tendency for prolonged OS (P = 0.065; RR=2.411; 95% CI, 0.946–6.142) (Table 1).In conclusion, ALC ≥1000 cells/mm3 recovery on day +23 was a good predictor for better survival in MM after APBSCT.

Table 1. Multivariate analysis for OS and PFS

VariablesOSPFS
RR95% CIPRR95% CIP
ANC, absolute neutrophil count; MNC, Mononuclear cell; ALC, absolute lymphocyte count 
β2 microglobulin ≤ 3 vs > 3 mg/l 3.497 1.32–9.25 0.012 2.215 0.962–5.101 0.062 
Serum albumin ≤ 3.7 vs > 3.7 g/dl    0.337 0.139–0.816 0.016 
ANC≥ 500/mm³ recovery days≤ 11 vs > 11 2.677 1.044–6.864 0.040 1.360 0.616–3.001 0.447 
Infused MNC dose≤ 3.4 vs > 3.4 ×10^8/kg    1.351 0.552–3.310 0.510 
Infused CD+34 dose≤ 6 vs > 6 ×10^6/kg    0.609 0.209–1.779 0.365 
ALC≥ 1000/mm³ recovery days≤ 23 vs > 23 2.411 0.946–6.142 0.065 3.710 1.576–8.736 0.003 
VariablesOSPFS
RR95% CIPRR95% CIP
ANC, absolute neutrophil count; MNC, Mononuclear cell; ALC, absolute lymphocyte count 
β2 microglobulin ≤ 3 vs > 3 mg/l 3.497 1.32–9.25 0.012 2.215 0.962–5.101 0.062 
Serum albumin ≤ 3.7 vs > 3.7 g/dl    0.337 0.139–0.816 0.016 
ANC≥ 500/mm³ recovery days≤ 11 vs > 11 2.677 1.044–6.864 0.040 1.360 0.616–3.001 0.447 
Infused MNC dose≤ 3.4 vs > 3.4 ×10^8/kg    1.351 0.552–3.310 0.510 
Infused CD+34 dose≤ 6 vs > 6 ×10^6/kg    0.609 0.209–1.779 0.365 
ALC≥ 1000/mm³ recovery days≤ 23 vs > 23 2.411 0.946–6.142 0.065 3.710 1.576–8.736 0.003 
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Topics:
lymphocytes, multiple myeloma, peripheral blood stem cell transplantation, beta 2-microglobulin, serum albumin, prognostic factors, cyclophosphamide, follow-up, granulocyte colony-stimulating factor, lymphoma

Author notes

Corresponding author

2005, The American Society of Hematology
2004
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