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LYMPHOCYTE RECONSTITUTION AFTER ALOGENIC TRANSPLANTATION, DOES EARLY RECOVERY HAVE ANY INFLUENCE IN SURVIVAL RATES?
Author(s):
Victoria Verdugo
,
Victoria Verdugo
Affiliations:
Hematology,Hospital Jerez de la Frontera,El Puerto de Santa María,Spain
Mª Angeles Correa Alonso
,
Mª Angeles Correa Alonso
Affiliations:
Hematology,Hospital Jerez de la Frontera,El Puerto de Santa María,Spain
Vicente Rubio Sanchez
Vicente Rubio Sanchez
Affiliations:
Hematology,Hospital Jerez de la Frontera,El Puerto de Santa María,Spain
(Abstract release date: 05/18/17) EHA Library. Verdugo V. 05/18/17; 182894; PB2181
Victoria Verdugo
Victoria Verdugo
Contributions
PDF Abstract
Abstract

Abstract: PB2181

Type: Publication Only

Background

Immune reconstitution after AloTPH has significant influence on the procedure final success. Studies have established that early lymphocyte recovery can influence survival rates, associated to a reduction in mortality unrelated relapse (NMR) and, in some studies, also to a reduction in relapse rate.

Aims

Analyze our patients survival rates in terms of lymphocyte reconstitution in absolute value on day + 30 and + 60 post-HSCT. Check if there is any relationship between the number of transfused CD34+ progenitors and LT3+ and see if that possible link affects the speed of recovery after transplant t- lymphocyte count.

Methods

Analysis of the lymphoid recovery in a retrospective study of 63 of 71 patients transplanted (ALO, and Haplo Unrelated Donor) by AML and ALL between 2008- 2015. (8 died before the day + 60).
Table 1 shows the characteristics of the pre-transplanted patients and analyze the influence of the parameters of the infused product (CD34x10 6 and LT x10 8 / kg r), type of transplant, GVHD presentation. treatment and reactivation of CMV on the recovery of absolute lymphocyte numbers in s + 30 and +60 days post transplantation using as cutt off <0.3x10 3 / ml. We have analyzed the ratio of the number of lymphocytes on day +60 with survival after transplantation.
It has made a statistical - analysis of OS and DFS in relation to the number of lymphocytes on day +30 and day +60 with Kaplan Meier compared the results with long-rank test and subsequent analysis of the variables collected with Cox Regression

Results
After analyzing the product infused we observe a relationship between LT and lymphocyte recovery on day + 30 (p: 0097, cor: 0223) and day +60 (p = 0.059, cor: 0257) but not with the CD34 + / Kg r. Table 2 shows the patient characteristics in lymphocyte absolute count in the day +60. We analyzed the overall survival (OS) and disease - free survival (DFS) and a decrease in OS with statistical difference was evident in patients with <.300 (p = 0.0029) on day +60 and day + 30 (p: 0.05), a decline also in DFS, with no statistically significant difference (p = 0.1). Multivariate analysis to determine which factors could influence the lymphoid recovery on day +60 and SG, we observed that the type of unrelated donor, myeloablative conditioning and ATG administration can influence a delay in this recovery. No differences were observed in the rest of the variables.

Conclusion
A delay in lymphocyte recovery is associated with a decrease in survival rates in our patients. Measures favoring an accelerated lymphocyte recovery (judicious use of thymoglobulin, adequate donor selection, and transplantation modality) could affect the post-transplant survival. It appears that the amount of infused product could play an important role in reconstitution, so it would be a factor to take into account prior to infusion.

Session topic: 22. Stem cell transplantation - Clinical

Abstract: PB2181

Type: Publication Only

Background

Immune reconstitution after AloTPH has significant influence on the procedure final success. Studies have established that early lymphocyte recovery can influence survival rates, associated to a reduction in mortality unrelated relapse (NMR) and, in some studies, also to a reduction in relapse rate.

Aims

Analyze our patients survival rates in terms of lymphocyte reconstitution in absolute value on day + 30 and + 60 post-HSCT. Check if there is any relationship between the number of transfused CD34+ progenitors and LT3+ and see if that possible link affects the speed of recovery after transplant t- lymphocyte count.

Methods

Analysis of the lymphoid recovery in a retrospective study of 63 of 71 patients transplanted (ALO, and Haplo Unrelated Donor) by AML and ALL between 2008- 2015. (8 died before the day + 60).
Table 1 shows the characteristics of the pre-transplanted patients and analyze the influence of the parameters of the infused product (CD34x10 6 and LT x10 8 / kg r), type of transplant, GVHD presentation. treatment and reactivation of CMV on the recovery of absolute lymphocyte numbers in s + 30 and +60 days post transplantation using as cutt off <0.3x10 3 / ml. We have analyzed the ratio of the number of lymphocytes on day +60 with survival after transplantation.
It has made a statistical - analysis of OS and DFS in relation to the number of lymphocytes on day +30 and day +60 with Kaplan Meier compared the results with long-rank test and subsequent analysis of the variables collected with Cox Regression

Results
After analyzing the product infused we observe a relationship between LT and lymphocyte recovery on day + 30 (p: 0097, cor: 0223) and day +60 (p = 0.059, cor: 0257) but not with the CD34 + / Kg r. Table 2 shows the patient characteristics in lymphocyte absolute count in the day +60. We analyzed the overall survival (OS) and disease - free survival (DFS) and a decrease in OS with statistical difference was evident in patients with <.300 (p = 0.0029) on day +60 and day + 30 (p: 0.05), a decline also in DFS, with no statistically significant difference (p = 0.1). Multivariate analysis to determine which factors could influence the lymphoid recovery on day +60 and SG, we observed that the type of unrelated donor, myeloablative conditioning and ATG administration can influence a delay in this recovery. No differences were observed in the rest of the variables.

Conclusion
A delay in lymphocyte recovery is associated with a decrease in survival rates in our patients. Measures favoring an accelerated lymphocyte recovery (judicious use of thymoglobulin, adequate donor selection, and transplantation modality) could affect the post-transplant survival. It appears that the amount of infused product could play an important role in reconstitution, so it would be a factor to take into account prior to infusion.

Session topic: 22. Stem cell transplantation - Clinical

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