Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Events

Early lymphocyte recovery after autologous stem cell transplantation predicts superior survival in mantle-cell lymphoma

Bone Marrow Transplantation volume 37, pages 865–871 (2006)Cite this article

Abstract

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-α 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/μl. 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 ⩾500 cells/μl compared with 18 patients with ALC-15 <500 cells/μl (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 ⩾500 cells/μl is associated with a significantly improved clinical outcome following ASCT in MCL.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Velders GA, Kluin-Nelemans JC, De Boer CJ, Hermans J, Noordijk EM, Schuuring E et al. Mantle-cell lymphoma: a population-based clinical study. J Clin Oncol 1996; 14: 1269–1274.

    Article  CAS  PubMed  Google Scholar 

  2. Weisenburger DD, Armitage JO . Mantle cell lymphoma – an entity comes of age. Blood 1996; 87: 4483–4494.

    CAS  PubMed  Google Scholar 

  3. Hiddemann W, Unterhalt M, Herrmann R, Woltjen HH, Kreuser ED, Trumper L et al. Mantle-cell lymphomas have more widespread disease and a slower response to chemotherapy compared with follicle-center lymphomas: results of a prospective comparative analysis of the German Low-Grade Lymphoma Study Group. J Clin Oncol 1998; 16: 1922–1930.

    Article  CAS  PubMed  Google Scholar 

  4. Samaha H, Dumontet C, Ketterer N, Moullet I, Thieblemont C, Bouafia F et al. Mantle cell lymphoma: a retrospective study of 121 cases. Leukemia 1998; 12: 1281–1287.

    Article  CAS  PubMed  Google Scholar 

  5. Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma [see comment]. N Engl J Med 1995; 333: 1540–1545.

    Article  CAS  PubMed  Google Scholar 

  6. Decaudin D, Brousse N, Brice P, Haioun C, Bourhis JH, Morel P et al. Efficacy of autologous stem cell transplantation in mantle cell lymphoma: a 3-year follow-up study. Bone Marrow Transplant 2000; 25: 251–256.

    Article  CAS  PubMed  Google Scholar 

  7. Vose JM, Bierman PJ, Weisenburger DD, Lynch JC, Bociek Y, Chan WC et al. Autologous hematopoietic stem cell transplantation for mantle cell lymphoma. Biol Blood Marrow Transplant 2000; 6: 640–645.

    Article  CAS  PubMed  Google Scholar 

  8. Dreyling M, Lenz G, Hoster E, Van Hoof A, Gisselbrecht C, Schmits R et al. Early consolidation by myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission significantly prolongs progression-free survival in mantle-cell lymphoma: results of a prospective randomized trial of the European MCL Network. Blood 2005; 105: 2677–2684.

    Article  CAS  PubMed  Google Scholar 

  9. Khouri IF, Saliba RM, Okoroji GJ, Acholonu SA, Champlin RE . Long-term follow-up of autologous stem cell transplantation in patients with diffuse mantle cell lymphoma in first disease remission: the prognostic value of beta2-microglobulin and the tumor score. Cancer 2003; 98: 2630–2635.

    Article  PubMed  Google Scholar 

  10. Milpied N, Gaillard F, Moreau P, Mahe B, Souchet J, Rapp MJ et al. High-dose therapy with stem cell transplantation for mantle cell lymphoma: results and prognostic factors, a single center experience. Bone Marrow Transplant 1998; 22: 645–650.

    Article  CAS  PubMed  Google Scholar 

  11. Oinonen R, Jantunen E, Itala M, Lehtinen T, Kuittinene O, Franssila K et al. Autologous stem cell transplantation in patients with mantle cell lymphoma. Leuk Lymphoma 2002; 43: 1229–1237.

    Article  PubMed  Google Scholar 

  12. Gordan LN, Sugrue MW, Lynch JW, Williams KD, Khan SA, Moreb JS . Correlation of early lymphocyte recovery and progression-free survival after autologous stem-cell transplant in patients with Hodgkin's and non-Hodgkin's Lymphoma. Bone Marrow Transplant 2003; 31: 1009–1013.

    Article  CAS  PubMed  Google Scholar 

  13. Kim H, Sohn HJ, Kim SE, Kang HJ, Parks S, Kim S et al. Lymphocyte recovery as a positive predictor of prolonged survival after autologous peripheral blood stem cell transplantation in T-cell non-Hodgkin's lymphoma. Bone Marrow Transplant 2004; 34: 43–49.

    Article  CAS  PubMed  Google Scholar 

  14. Porrata LF, Gertz MA, Inwards DJ, Litzow MR, Lacy MQ, Tefferi A et al. Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation in multiple myeloma or non-Hodgkin lymphoma. Blood 2001; 98: 579–585.

    Article  CAS  PubMed  Google Scholar 

  15. Porrata LF, Inwards DJ, Micallef IN, Ansell SM, Geyer SM, Marlovic SN . Early lymphocyte recovery post-autologous haematopoietic stem cell transplantation is associated with better survival in Hodgkin's disease. Br J Haematol 2002; 117: 629–633.

    Article  PubMed  Google Scholar 

  16. Porrata LF, Litzow MR, Tefferi A, Letendre L, Kumar S, Geyer SM et al. Early lymphocyte recovery is a predictive factor for prolonged survival after autologous hematopoietic stem cell transplantation for acute myelogenous leukemia. Leukemia 2002; 16: 1311–1318.

    Article  CAS  PubMed  Google Scholar 

  17. Porrata LF, Gertz MA, Litzow MR, Lacy MQ, Dispenzieri A, Inwards DJ et al. Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation for patients with primary systemic amyloidosis. Clin Cancer Res 2005; 11: 1210–1218.

    CAS  PubMed  Google Scholar 

  18. Nieto Y, Shpall EJ, McNiece IK, Nawaz S, Beaudet J, Rosinski S et al. Prognostic analysis of early lymphocyte recovery in patients with advanced breast cancer receiving high-dose chemotherapy with an autologous hematopoietic progenitor cell transplant. Clin Cancer Res 2004; 10: 5076–5086.

    Article  CAS  PubMed  Google Scholar 

  19. Porrata LF, Ingle JN, Litzow MR, Geyer SM, Markovic SN . Prolonged survival associated with early lymphocyte recovery after autologous hematopoietic stem cell transplantation for patients with metastatic breast cancer. Bone Marrow Transplant 2001; 28: 865–871.

    Article  CAS  PubMed  Google Scholar 

  20. Porrata LF, Litzow MR, Inwards DJ, Gastineau DA, Moore SB, Pineda AA et al. Infused peripheral blood autograft absolute lymphocyte count correlates with day 15 absolute lymphocyte count and clinical outcome after autologous peripheral hematopoietic stem cell transplantation in non-Hodgkin's lymphoma. Bone Marrow Transplant 2004; 33: 291–298.

    Article  CAS  PubMed  Google Scholar 

  21. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med 1993; 329: 987–994.

  22. Kaplan E, Meier P . Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457–481.

    Article  Google Scholar 

  23. Cox D . Regression models and life-tables. J R Stat Soc (B) 1972; 34: 187–202.

    Google Scholar 

  24. Harrell Jr FE, Califf RM, Pryor DB, Lee KL, Rosati RA . Evaluating the yield of medical tests. JAMA 1982; 247: 2543–2546.

    Article  PubMed  Google Scholar 

  25. Brugger W, Hirsch J, Grunebach F, Repp R, Brossart P, Vogel W et al. Rituximab consolidation after high-dose chemotherapy and autologous blood stem cell transplantation in follicular and mantle cell lymphoma: a prospective, multicenter phase II study. Ann Oncol 2004; 15: 1691–1698.

    Article  CAS  PubMed  Google Scholar 

  26. Mangel J, Leitch HA, Connors JM, Buckstein R, Imrie K, Spaner D et al. Intensive chemotherapy and autologous stem-cell transplantation plus rituximab is superior to conventional chemotherapy for newly diagnosed advanced stage mantle-cell lymphoma: a matched pair analysis. Ann Oncol 2004; 15: 283–290.

    Article  CAS  PubMed  Google Scholar 

  27. Porrata LF, Markovic SN . Timely reconstitution of immune competence affects clinical outcome following autologous stem cell transplantation. Clin Exp Med 2004; 4: 78–85.

    Article  CAS  PubMed  Google Scholar 

  28. Barnes DW, Loutit JF . Treatment of murine leukaemia with X-rays and homologous bone marrow. II. Br J Haematol 1957; 3: 241–252.

    Article  CAS  PubMed  Google Scholar 

  29. Horowitz MM, Gale RP, Sondel PM, Goldman JM, Kersey J, Kolb HJ et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990; 75: 555–562.

    CAS  PubMed  Google Scholar 

  30. Kolb HJ, Schattenberg A, Goldman JM, Hertenstein B, Jacobsen N, Arcese W et al. European Group for Blood & Marrow Transplantation Working Party Chronic, L. Graft-versus-leukemia effect of donor lymphocyte transfusions in marrow grafted patients [see comment]. Blood 1995; 86: 2041–2050.

    CAS  PubMed  Google Scholar 

  31. Perreault C, Belanger R, Bonny Y, Gyger M, Roy DC . Critical issues in bone marrow transplantation immunology. Bone Marrow Transplant 1991; 7 (Suppl 1): 24–25.

    PubMed  Google Scholar 

  32. Pion S, Fontaine P, Baron C, Gyger M, Perreault C . Immunodominant minor histocompatibility antigens expressed by mouse leukemic cells can serve as effective targets for T cell immunotherapy. J Clin Invest 1995; 95: 1561–1568.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Truitt RL, Atasoylu AA . Contribution of CD4+ and CD8+ T cells to graft-versus-host disease and graft-versus-leukemia reactivity after transplantation of MHC-compatible bone marrow. Bone Marrow Transplant 1991; 8: 51–58.

    CAS  PubMed  Google Scholar 

  34. Joao C, Ogle BM, Gay-Rabinstein C, Platt JL, Cascalho M . B cell-dependent TCR diversification. J Immunol 2004; 172: 4709–4716.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Tanya Hoskin, Biostatistics, Mayo Clinic Rochester for her help with statistical methods. This study was funded by the University of Iowa. Mayo Clinic Lymphoma SPORE CA97274 and Fundação para a Ciência e Tecnologia, Lisbon, Portugal (BD 6797/2001).

Author information

Authors and Affiliations

  1. Hematology Department, Portuguese Institute of Oncology, Lisbon, Portugal

    C Joao

  2. Division of Hematology/Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    C Joao, L F Porrata, D J Inwards, S M Ansell, I N Micallef, P B Johnston, D A Gastineau & S N Markovic

Authors
  1. C Joao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L F Porrata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D J Inwards
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S M Ansell
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. I N Micallef
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P B Johnston
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D A Gastineau
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S N Markovic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L F Porrata.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Joao, C., Porrata, L., Inwards, D. et al. Early lymphocyte recovery after autologous stem cell transplantation predicts superior survival in mantle-cell lymphoma. Bone Marrow Transplant 37, 865–871 (2006). https://doi.org/10.1038/sj.bmt.1705342

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1705342

Keywords

This article is cited by

Search

Advanced search

Quick links