Author(s): Porrata LF, Inwards DJ, Ansell SM, Micallef IN, Johnston PB,
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Abstract A specific predictor during routine follow-up to ascertain risk for postautologous peripheral blood hematopoietic stem cell transplantation (post-APHSCT) relapse in non-Hodgkin lymphoma (NHL) has not been identified. Thus, we studied if new-onset lymphopenia measured by the absolute lymphocyte count (ALC) was a marker of post-APHSCT NHL relapse. ALC was obtained at the time of confirmed relapse, and at last follow-up with no relapse. From 1993 until 2005, 269 patients treated with APHSCT for diffuse large B-cell lymphoma (DLBCL) were included in this study. Patients at last follow-up without relapse (N=137) had a higher ALC compared with those with low ALC at the time of confirmed relapsed (N=132) (median ALC x10(9)/L of 1.66 versus 0.71, P < .0001, respectively). ALC at follow-up was a strong predictor for relapse with an area under the curve (AUC)=0.86 (P < .0001). An ALC <1.0 x 10(9)/L at the time of confirmed relapse had a positive predictive value of 89\% and a positive likelihood ratio of 8.4 to predict relapse post-APHSCT. Patients with an ALC > or =1.0 x 10(9)/L (N=147) had a cumulative incidence of relapse of 19\% versus 92\%, with an ALC <1.0 x 10(9)/L (N=122) (P < .0001). This study suggests that new-onset lymphopenia measured by ALC can be used as marker to assess risk of DLBCL relapse during routine follow-up for after APHSCT. Copyright (c) 2010 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
This article was published in Biol Blood Marrow Transplant
and referenced in Journal of Cell Science & Therapy