1. ¹Division of Oncology, Department of Medicine, Section of Bone Marrow Transplantation and Leukemia, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA
2. ²Division of Biostatistics, Department of Preventive Medicine and Public Health, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA

Correspondence: Dr HJ Khoury, Department of Hematology, Emory University School of Medicine, 1365C Clifton Road NE, Suite 3007, Atlanta, GA 30322, USA. E-mail: hkhoury@emory.edu

Received 10 April 2007; Revised 4 June 2007; Accepted 5 June 2007; Published online 6 August 2007.

Abstract

The purpose of this study was to analyze the prognostic significance of early lymphocyte recovery after autologous SCT (ASCT) in the setting of routine post transplant administration of GM-CSF in patients with non-Hodgkin's lymphoma (NHL). This is a single institution retrospective comparative outcome analysis in a cohort of 268 relapsed chemosensitive NHL patients divided into two groups (early and late lymphocyte recovery) based on absolute lymphocyte counts (ALC) obtained on post transplant day +15 (ALC500, n=151 (56%) and ALC<500, n=117 (44%)). Patient's characteristics were well-balanced between the two groups with regard to age, sex, preparative regimen, prior therapy, time from diagnosis to transplant and number of CD34+ cells infused. Post transplant complications were comparable in the two groups. Late lymphocyte recovery (ALC<500 on day +15) was independently associated with a delay in platelet recovery (29 vs 21 days, P=0.0003) in patients who have not received pre-transplant rituximab. With a median follow-up of 22 months, no associations between early lymphocyte recovery and improvement of disease-free and overall survival were observed for either low- or intermediate-grade NHL. In conclusion, in this large single-centered retrospective analysis, where patients received routine post transplant GM-CSF, early lymphocyte recovery was not associated with favorable outcomes.