Early immune recovery after autologous transplantation in non-Hodgkin lymphoma patients: predictive factors and clinical significance

Abstract

Limited data is available about the factors affecting early immune recovery or its clinical significance after autologous stem cell transplantation (auto-SCT). We prospectively analyzed factors affecting early immune recovery and outcome among 72 non-Hodgkin lymphoma (NHL) patients. Absolute lymphocyte count 15 d after auto-SCT (ALC-15) ≥ 0.5 × 10⁹/L was associated with the use of plerixafor (p = 0.004), the number of CD34⁺ cells (p = 0.015), and CD34⁺ CD38⁻ cells (p = 0.005) in the grafts. ALC-15 ≥ 0.5 × 10⁹/L was associated with improved overall survival (p = 0.021). In patients with aggressive histology, ALC-15 ≥ 0.5 × 10⁹/L was beneficial in regard to both progression-free survival (p = 0.015) and overall survival (p = 0.002). Early immune recovery seems to be important in transplanted patients with NHL and, therefore, an easy and affordable method for disease-related risk analysis. Patients with aggressive histology and slow immune recovery may need additional post-transplant treatment.

Keywords:

• Autologous transplantation
• ALC-15
• graft analysis
• immune recovery
• non-Hodgkin lymphoma
• outcome

Acknowledgements

Dr. Valtola is grateful for the scholarships granted by the Research Foundation of Hematological Diseases, the Cancer Fund of North Savo District, Paavo Koistinen Fund, the Finnish Cultural Foundation, The Finnish-Norwegian Medical Foundation and The Finnish Medical Society Duodecim. The help of research nurses Eeva Kiljander and Kirsi Kvist-Mäkelä is also gratefully acknowledged.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2015.1129537.

Dr. Valtola has received honoraria from Sanofi and Janssen-Cilag, Dr. Varmavuo has received consultancy fees from Roche and Celgene. Dr. Keskinen has participated Medical Advisory Board organized by TEVA. Dr. Jantunen has received honoraria from Genzyme and Sanofi and has participated in EU Leadership meeting organized by Genzyme as well as Medical Advisory Board meeting organized by Genzyme and Amgen. The other authors declare no conflicts of interest.

Funding

The study was supported by VTR grant from North Savo Hospital District.