Gordan L N, Sugrue M W, Lynch J W, Williams K D, Khan S A, Moreb J S
Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA.
Bone Marrow Transplant. 2003 Jun;31(11):1009-13. doi: 10.1038/sj.bmt.1704050.
The importance of the association between early lymphocyte recovery and outcome has not been well studied in autologous stem cell transplantation (ASCT). In this retrospective study, we analyzed 90 consecutive patients with non-Hodgkin's and Hodgkin's lymphoma who underwent ASCT. Patients were divided into two groups: group 1 with absolute lymphocyte count (ALC) on day +15 below the median of 667/mm(3), and group 2 with ALC >or=667/mm(3). The median progression-free survival (PFS), but not overall survival (OS), was significantly longer in group 2 when compared to group 1 (16 months vs not reached P=0.02). Group 2 patients also had significantly shorter hospital stay, received higher CD34(+) cell dose, and had shorter time to neutrophil recovery. Multivariate analysis demonstrated day +15 ALC to be an independent prognostic indicator for PFS, but not OS, while CD34(+) cell dose and the number of pretransplant treatments were better predictors for both PFS and OS. We conclude that higher day +15 ALC may independently predict better PFS after ASCT for lymphoma patients; however, whether this merely reflects faster overall recovery caused by higher infused CD34(+) cell dose and less pretransplant therapy needs further investigation.
在自体干细胞移植（ASCT）中，早期淋巴细胞恢复与预后之间关联的重要性尚未得到充分研究。在这项回顾性研究中，我们分析了90例连续接受ASCT的非霍奇金淋巴瘤和霍奇金淋巴瘤患者。患者被分为两组：第1组在+15天时的绝对淋巴细胞计数（ALC）低于中位数667/mm³，第2组的ALC≥667/mm³。与第1组相比，第2组的无进展生存期（PFS）中位数显著更长（16个月对未达到，P = 0.02），但总生存期（OS）无显著差异。第2组患者的住院时间也显著更短，接受的CD34⁺细胞剂量更高，中性粒细胞恢复时间更短。多因素分析表明，+15天时的ALC是PFS的独立预后指标，但不是OS的独立预后指标，而CD34⁺细胞剂量和移植前治疗次数是PFS和OS的更好预测指标。我们得出结论，较高的+15天时ALC可能独立预测淋巴瘤患者ASCT后的PFS更好；然而，这是否仅仅反映了较高的输注CD34⁺细胞剂量和较少的移植前治疗导致的更快的整体恢复，还需要进一步研究。
