Analysis of absolute lymphocyte count and other factors predicting survival in patients with Hodgkin’s lymphoma following autologous stem cell transplantation
Authors:
H. Mociková; B. Vacková; R. Pytlík; P. Obrtlíková; M. Trněný
Authors‘ workplace:
Univerzita Karlova v Praze, 1. lékařská fakulta, I. interní klinika – klinika hematologie 1. LF a VFN
Published in:
Transfuze Hematol. dnes,16, 2010, No. 1, p. 25-29.
Category:
Comprehensive Reports, Original Papers, Case Reports
Overview
Introduction.
This retrospective study analyzed risk factors predicting treatment failure and survival in patients with Hodgkinęs lymphoma following autologous stem cell transplantation. Analyzed factors: absolute lymphocyte counts prior to stem cell collection, day+15 and day +90 following transplantation, age at transplantation, clinical stage at relapse, progression/early and late relapse, response to salvage chemotherapy, positivity of positron emission tomography prior to transplantation, number of infused CD34+ cells, recovery of neutrophile leucocytes and occurence of serious infections within 6 months following transplantation. Patients and methods. The study analyzed 33 patients treated with autologous transplantation between years 2000 and 2008. Median age was 34 years, 17 relapsed patients (51%) were in clinical stage III or IV. Early relapse within one year after previous therapy was diagnosed in 15 patients (45%). Chemosensitivity of lymphoma prior to transplantation was proved in 21 patients (64%). Positron emission tomography prior to transplantation was offered to 21 patients with persisting positive findings in 10 patients (48%). Median number of infused CD34+ cells was 6.8x106/kg. Median absolute lymphocyte count prior to stem cell collection was 1.2x109/L, day +15 post-transplantation was 0.7x109/L and day +90 post-transplantation was 1.35x109/L. Results. Median follow - up of the group was 3.6 years. 3 - year actuarial overall survival and progression-free survival are 82% and 71%. The only factor significantly associated with progression-free survival in univariate analysis was absolute lymphocyte count day +90 ≥ 0.75x109/L (HR= 0.205, 95% confidence interval: 0.055 – 0.757, p = 0.017). None of analysed factors was predictive for overall or progression-free survival in multivariate analyses. Conclusions. In our study only absolute lymphocyte count day +90 following transplantation with cut-off over 0.75x109/L was significantly associated with improved progression-free survival.
Key words:
autologous stem cell transplantation, therapeutic response, prognostic factors, absolute lymphocyte count
Sources
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