Joao C, Porrata L F, Inwards D J, Ansell S M, Micallef I N, Johnston P B, Gastineau D A, Markovic S N
Hematology Department, Portuguese Institute of Oncology, Lisbon, Portugal.
Bone Marrow Transplant. 2006 May;37(9):865-71. doi: 10.1038/sj.bmt.1705342.
Autologous stem cell transplantation (ASCT) is an effective treatment strategy for mantle-cell lymphoma (MCL) demonstrating significantly prolonged progression-free survival (PFS) when compared to interferon-alpha maintenance therapy of patients in first remission. The study of absolute lymphocyte count at day 15 (ALC-15) after ASCT as a prognostic factor in non-Hodgkin lymphoma (NHL) included different lymphoma subtypes. The relationship of ALC-15 after ASCT in MCL has not been specifically addressed. We evaluated the impact of ALC-15 recovery on survival of MCL patients undergoing ASCT. We studied 42 consecutive MCL patients who underwent ASCT at the Mayo Clinic in Rochester from 1993 to 2005. ALC-15 threshold was set at 500 cells/microl. The median follow-up after ASCT was 25 months (range, 2-106 months). The median overall survival (OS) and PFS times were significantly better for the 24 patients who achieved an ALC-15 >or=500 cells/microl compared with 18 patients with ALC-15 <500 cells/microl (not reached vs 30 months, P<0.01 and not reached vs 16 months, P<0.0006, respectively). Multivariate analysis demonstrated ALC-15 to be an independent prognostic factor for OS and PFS. The ALC-15 >or=500 cells/microl is associated with a significantly improved clinical outcome following ASCT in MCL.
自体干细胞移植（ASCT）是套细胞淋巴瘤（MCL）的一种有效治疗策略，与首次缓解期患者接受α干扰素维持治疗相比，其无进展生存期（PFS）显著延长。将ASCT后第15天的绝对淋巴细胞计数（ALC-15）作为非霍奇金淋巴瘤（NHL）的预后因素进行研究，纳入了不同的淋巴瘤亚型。ASCT后MCL中ALC-15的关系尚未得到专门研究。我们评估了ALC-15恢复对接受ASCT的MCL患者生存的影响。我们研究了1993年至2005年在罗切斯特梅奥诊所接受ASCT的42例连续MCL患者。ALC-15阈值设定为每微升500个细胞。ASCT后的中位随访时间为25个月（范围2 - 106个月）。与18例ALC-15<500个细胞/微升的患者相比，24例ALC-15≥500个细胞/微升的患者的中位总生存期（OS）和PFS时间显著更长（未达到与30个月，P<0.01；未达到与16个月，P<0.0006）。多变量分析表明ALC-15是OS和PFS的独立预后因素。MCL患者接受ASCT后，ALC-15≥500个细胞/微升与显著改善的临床结局相关。
