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Multiple Myeloma: Treatment

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 volume 18, pages 1085–1092 (2004)Cite this article

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.

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    L F Porrata, M A Gertz, M R Litzow, D A Gastineau, M Q Lacy, A Dispenzieri, D S Snow & S N Markovic

  2. The Cancer Center Statistics, Section of Biostatistics, Mayo Clinic, Rochester, MN, USA

    S M Geyer

  3. Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    D A Gastineau, S B Moore, A A Pineda, K L Bundy & D J Padley

  4. Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    D Persky

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  1. L F Porrata
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Correspondence to L F Porrata.

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Porrata, L., Gertz, M., Geyer, S. et al. 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, 1085–1092 (2004). https://doi.org/10.1038/sj.leu.2403341

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