Early lymphocyte recovery predicts superior outcomes after unmanipulated haploidentical blood and marrow transplant for acute myeloid leukemia

Abstract

We investigated whether early lymphocyte recovery, after unmanipulated haploidentical blood and marrow transplant (HBMT), affected clinical outcomes in 134 patients with acute myeloid leukemia (AML). Lymphocyte recovery was based on the absolute lymphocyte count on day 30 (ALC-30). Patients with high ALC-30 (≥294 cells/μL) had higher overall survival (OS) (77.6% vs 59.7%, P=.020) and higher leukemia-free survival (LFS) (74.6% vs 53.7%, P=.016) than those with low ALC-30 values. Multivariate analysis demonstrated that a high ALC-30 was associated with improved overall survival (HR: 0.443, 95% CI: 0.233-0.841; P=.013) and LFS (HR: 0.499, 95% CI: 0.275-0.906; P=.022). Our results suggest that the ALC-30 can predict a superior outcome after unmanipulated HBMT.

Keywords: absolute lymphocyte count; acute myeloid leukemia; immune recovery; lymphocyte recovery; transplant outcomes; unmanipulated haploidentical blood and marrow transplant.