Early lymphocyte recovery and outcomes after umbilical cord blood transplantation (UCBT) for hematologic malignancies. Biol Blood Marrow Transplant 2011 Jun;17(6):831-40
Date
09/14/2010Pubmed ID
20831896Pubmed Central ID
PMC3412271DOI
10.1016/j.bbmt.2010.08.022Scopus ID
2-s2.0-79956010659 (requires institutional sign-in at Scopus site) 29 CitationsAbstract
Rapid lymphocyte recovery after bone marrow or peripheral blood transplantation is associated with improved survival. However, the impact of early lymphocyte recovery has not been examined after umbilical cord blood transplant (UCBT). We evaluated lymphocyte recovery in 360 consecutive patients with hematologic malignancy that underwent UCBT between 2001 and 2007. Uniform myeloablative (MA), reduced intensity conditioning (RIC) and graft-versus-host disease prophylaxis regimens were used. In multivariate analysis, an absolute leukocyte count (ALC) >200 × 10(6)/L at day 30 (n = 73) after MA conditioning was associated with superior 2-year overall survival (OS) (73% versus 61%; P = .02) (relative risk [RR]: 2.29; 95% confidence interval [CI]: 1.15-4.56), progression-free survival (PFS) (68% versus 54%; P = .05) (RR: 1.96; 95% CI: 0.99-3.86) and less transplant-related mortality (8% versus 28%, P < .01) (RR: 4.38; 95% CI: 1.65-11.60) compared to ≤200 × 10(6)/L (n = 43). Similarly, an ALC >200 × 10(6)/L at day 42 (n = 105) after RIC was associated with superior 2-year OS (59% versus 41%, P < .01) (RR: 2.10; 95% CI: 1.3-3.41) and PFS (46% versus 36%, P = .05) (RR: 1.58; 95% CI: 1.01-2.49) compared to ≤200 × 10(6)/L (n = 55). There was no significant relationship between ALC and relapse. Rapid lymphocyte recovery early after UCBT predicts better survival in patients with hematologic malignancies.
Author List
Burke MJ, Vogel RI, Janardan SK, Brunstein C, Smith AR, Miller JS, Weisdorf D, Wagner JE, Verneris MRAuthor
Michael James Burke MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Child
Child, Preschool
Cord Blood Stem Cell Transplantation
Disease-Free Survival
Female
Graft vs Host Disease
Hematologic Neoplasms
Humans
Infant
Lymphocyte Count
Male
Middle Aged
Multivariate Analysis
Pregnancy
Recurrence
Time Factors
Transplantation Conditioning
Treatment Outcome
Young Adult