Abstract

JAIME FAGUNDO, Juan C; ROMERO GONZALEZ, Adrián; ANOCETO MARTINEZ, Ainel  and  ARENCIBIA NUNEZ, Alberto A. Early lymphocyte recovery as a prognostic factor after hematopoietic stem cell transplantation. Rev Cubana Hematol Inmunol Hemoter [online]. 2014, vol.30, n.3, pp.223-232. ISSN 0864-0289.

Introduction: early lymphocyte recovery is a prognostic factor related to a higher event-free survival and overall survival in patients who have received hematopoietic transplantation. Objective: eo determine the prognostic value of absolute lymphocyte count (ALC). Method: a study in pediatric patients with hematological malignancies transplanted at the Institute of Hematology and Immunology from 1986 to 2011 was performed. The study group included 36 patients: 15 with acute lymphoid leukemia, 13 with acute myeloid leukemia, 6 with chronic myeloid leukemia and 2 with non Hodgkin lymphoma. Twenty transplants were autologous and 13 allogeneic. As stem cell source, bone marrow was used in 22 patients and peripheral blood in 14. Results : 60,9 % of the autologous transplants reached an absolute lymphocyte count = 500 x mm3 on day 15 (ALC-15), whereas in the allogeneic this was achieved in 53,8 %. Peripheral blood had a higher ALC-15 than bone marrow, 78,6 % and 45,4 %, respectively (p = 0.049). Prognostic factors associated to worse overall survival were sepsis (p <0.001), ALC-15 <500 x mm3 (p = 0.001) and relapse (p = 0.03). Kapplan-Meier curves showed better overall survival and event-free survival after five years in patients with ALC-15 = 500 x mm3 (85 % vs. 15 %, p <0.001). Conclusions: the ALC-15 = 500 x mm3 is a simple and useful tool to predict a better outcome in pediatric patients undergoing hematopoietic transplantation.

Keywords : absolute lymphocyte count; prognostic factors; hematopoietic transplantation.

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