Correlation of lymphocyte recovery and progression-free survival after autologous stem cell transplantation in patients with Hodgkin's lymphoma

Objectives: The aim of this study was to correlate lymfocyte recovery and progression-free survival (PFS) after autologous stem cell transplantation (ASCT) in patients (pts) with primary progressive or recurrent Hodgkin lymphoma (HL) and to analyze factors associated with outcome. Patients and methods: We retrospectively analyzed 33 pts with HL who underwent ASCT between 2000 and 2008. Factors analyzed: clinical stage at relapse, relapse 12months, chemosensitivity of relapse, infused lymphocytes and CD34 cells, pre-apheresis absolute lymfocyte count (ALC), day 15 and day 90 ALC following ASCT, engraftment characteristics and infections within first 6 months post-transplant. Results: At the time of ASCT 14/33 patients (pts) were in CR, 7/33 in PR, 8/33 in SD and 4/33 pts were primary progressive HL. Median age:34 years (range 19-57). Median CD34 cell infused: 6.8x[10.sup.6]/kg (range 4.1-34.7). Median pre-apheresis ALC: 1.2x109/L, day 15 ALC: 0.7 x [10.sup.9]/L, day 90 ALC: 1.35 x [10.sup.9]/ L. Median follow-up: 3.6years. 3 year median overall survival (OS) and PFS are 82% and 71%. There was no association between PFS and remission status at the time of ASCT, infused lymphocytes and CD34 cell number, pre-apheresis ALC, day 15 ALC, or engrafment times. Day 90 ALC (HR = 0.205, p = 0.017) was significantly associated with PFS in univariate analysis and multivariate analysis. Conclusions: In our study only ALC day 90 was significantly associated with improved PFS suggesting long-term lymphoid reconstitution may be an important factor for tumor control.