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Lymphoid Reconstitution

Effect of slow lymphocyte recovery and type of graft-versus-host disease prophylaxis on relapse after allogeneic bone marrow transplantation for acute myelogenous leukemia

Bone Marrow Transplantation volume 28, pages 951–956 (2001)Cite this article

Abstract

Allogeneic BMT is potentially curative for patients with acute myelogenous leukemia (AML) in first remission. However, many patients relapse after transplantation. Various immunotherapeutic options have been attempted with variable success in preventing relapse. Early identification of patients at high risk for relapse could allow prompt intervention. We examined the effect of slow lymphocyte recovery after sibling-matched allogeneic BMT on the risk of relapse in patients with AML. We also examined the effect of prednisone-containing GVHD prophylaxis on the rate of lymphocyte recovery. Patients with absolute lymphocyte count (ALC) <150 × 106/l by day +30 had a 3.5-fold higher risk of relapse (P = 0.0088) and a lower overall survival (P = 0.0079) than patients with a higher ALC. We did not find correlation between lymphocyte count determined earlier in the post-transplantation course (day +21) and the risk of relapse. Patients receiving prednisone had a significantly lower ALC at day +30 than those who did not receive prednisone (289 vs549 × 106/l, P = 0.002). We conclude that a slow lymphocyte recovery after allogeneic BMT for AML is strongly predictive of subsequent relapse and that the type of GVHD prophylaxis should be considered when analyzing lymphocyte recovery. Bone Marrow Transplantation (2001) 28, 951–956.

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Acknowledgements

We thank Ms Norine E Huneke for her expert assistance with BMT database management.

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Authors and Affiliations

  1. Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA

    S Kumar, DA Gastineau, MA Gertz, DJ Inwards, MQ Lacy, A Tefferi & MR Litzow

  2. Division of Radiation Oncology, Mayo Clinic, Rochester, MN, USA

    MG Chen

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Kumar, S., Chen, M., Gastineau, D. et al. Effect of slow lymphocyte recovery and type of graft-versus-host disease prophylaxis on relapse after allogeneic bone marrow transplantation for acute myelogenous leukemia. Bone Marrow Transplant 28, 951–956 (2001). https://doi.org/10.1038/sj.bmt.1703262

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