Lymphocyte recovery as a positive predictor of prolonged survival after autologous peripheral blood stem cell transplantation in T-cell non-Hodgkin's lymphoma

We performed a retrospective study on recovery and survival of patients with T-cell NHL after autologous peripheral blood stem cell transplantation (APBSCT). Of a total of 39 patients with high-risk T-cell NHL, 33 were analyzed. Six patients who experienced early treatment mortality without full lymphocyte recovery were excluded. We chose absolute lymphocyte count (ALC) recovery as 1000 cells/mul as a cutoff value. ALC recovery day was defined as the first of 3 consecutive days with ALC above 1000 cells/mul. Univariate analysis revealed that age younger than 45 years, good international prognostic index, chemosensitive disease prior to APBSCT, and early ALC recovery ( 1000 cells/mul within 25 days of APBSCT) were predictors of prolonged survival. Multivariate analyses confirmed that chemosensitive disease prior to APBSCT and early ALC recovery were strongly associated with better overall survival ( OS) ( P = 0.005 and 0.011, respectively) and progression-free survival (PFS) (P<0.001 and P = 0.013, respectively). Our finding, that ALC recovery >= 1000 cells/mu l is an independent predictor of OS and PFS in T-cell NHL after APBSCT, suggests that earlier immune recovery may contribute to longer survival.