1. ¹Division of Hematology, Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
2. ²Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St, SW, Rochester, MN 55905, USA
3. ³Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905,USA

Correspondence: Dr SN Markovic, Department of Hematology and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA. E-mail: markovic.svetomir@mayo.edu

Received 23 April 2003; Accepted 5 July 2003; Published online 15 December 2003.

Abstract

Absolute lymphocyte count at day 15 (ALC-15) after autologous peripheral blood hematopoietic stem cell transplantation (APHSCT) is an independent prognostic factor for survival in non-Hodgkin's lymphoma (NHL). Factors affecting ALC-15 remain unknown. We hypothesized that dose of infused autograft lymphocytes (A-ALC) directly impacts upon ALC-15. A total of 190 consecutive NHL patients received A-ALC between 1993 and 2001. The primary end point was correlation between A-ALC and ALC-15. A strong correlation was identified (r=0.71). A higher A-ALC was infused into patients achieving an ALC-15 500/l vs ALC-15 <500/l (median of 0.68 10⁹/kg (0.04–2.21 10⁹/kg), vs 0.34 10⁹/kg (0.04–1.42 10⁹/kg), P<0.0001). The median follow-up for all patients was 36 months (maximum of 109 months). The A-ALC threshold was determined at 0.5 10⁹/kg. The median overall survival (OS) and progression-free survival (PFS) times were longer in patients who received an A-ALC 0.5 10⁹/kg vs A-ALC <0.5 10⁹/kg (76 vs 17 months, P<0.0001; 49 vs 10 months, P<0.0001, respectively). Multivariate analysis demonstrated A-ALC to be an independent prognostic indicator for OS and PFS. These data support our hypothesis that ALC-15 and survival are dependent upon the dose of infused A-ALC in NHL.