User login
Photo courtesy of VCU
Massey Cancer Center
Results of a retrospective study suggest lymphocyte recovery is associated with outcomes after allogeneic hematopoietic stem cell transplant (HSCT).
Researchers found that, after transplant, lymphocyte recovery occurred in 1 of 3 general patterns.
And these patterns were associated with the rate of survival, relapse, and graft-vs-host disease (GVHD), as well as the need for further donor immune cell infusions to treat the patients’ disease.
Amir Toor, MD, of VCU Massey Cancer Center in Richmond, Virginia, and his colleagues reported these findings in Biology of Blood & Marrow Transplantation.
The team had examined lymphocyte recovery and clinical outcome data from a phase 2 trial (NCT00709592) of 41 patients who received an HSCT from a related or unrelated donor.
As part of the trial protocol, the patients underwent low-dose radiation therapy and received 1 of 2 different doses of anti-thymocyte globulin as GVHD prophylaxis.
The researchers found that, after transplant, lymphocyte recovery followed 1 of 3 general patterns that correlated with patient outcomes.
“We began considering lymphocyte reconstitution following stem cell transplantation as similar to population growth models,” Dr Toor explained. “So we graphed the lymphocyte counts of our patients at various times following their transplant as a logistic function and observed distinct patterns that correlated with clinical outcomes.”
Patients in group A experienced fast, early lymphoid expansion, culminating in a high absolute lymphoid count (ALC) within 2 months of HSCT. Group B experienced a slower, but steady, lymphoid expansion that peaked much later than group A with a lower ALC. Group C experienced very poor lymphocyte recovery that demonstrated an early, but brief, lymphoid expansion with a very low ALC.
Group B had the best survival rate—86%—compared to 67% in group A and 30% in group C. Relapse rates between groups A and B were similar, at 33% and 29%, respectively, while group C experienced a 90% relapse rate.
GVHD occurred in 67% of patients in group A, 43% in group B, and 10% in group C. And adoptive immunotherapy with donor cell infusions was required for 13% of patients in group A, 21% in group B, and 70% in group C.
“Our goal is to use this data to develop models that can predict complications from stem cell transplantation,” Dr Toor said. “Then, we may be able to intervene at key points in time with appropriate clinical treatments that will make the most positive impact on patients’ outcomes.” 
Photo courtesy of VCU
Massey Cancer Center
Results of a retrospective study suggest lymphocyte recovery is associated with outcomes after allogeneic hematopoietic stem cell transplant (HSCT).
Researchers found that, after transplant, lymphocyte recovery occurred in 1 of 3 general patterns.
And these patterns were associated with the rate of survival, relapse, and graft-vs-host disease (GVHD), as well as the need for further donor immune cell infusions to treat the patients’ disease.
Amir Toor, MD, of VCU Massey Cancer Center in Richmond, Virginia, and his colleagues reported these findings in Biology of Blood & Marrow Transplantation.
The team had examined lymphocyte recovery and clinical outcome data from a phase 2 trial (NCT00709592) of 41 patients who received an HSCT from a related or unrelated donor.
As part of the trial protocol, the patients underwent low-dose radiation therapy and received 1 of 2 different doses of anti-thymocyte globulin as GVHD prophylaxis.
The researchers found that, after transplant, lymphocyte recovery followed 1 of 3 general patterns that correlated with patient outcomes.
“We began considering lymphocyte reconstitution following stem cell transplantation as similar to population growth models,” Dr Toor explained. “So we graphed the lymphocyte counts of our patients at various times following their transplant as a logistic function and observed distinct patterns that correlated with clinical outcomes.”
Patients in group A experienced fast, early lymphoid expansion, culminating in a high absolute lymphoid count (ALC) within 2 months of HSCT. Group B experienced a slower, but steady, lymphoid expansion that peaked much later than group A with a lower ALC. Group C experienced very poor lymphocyte recovery that demonstrated an early, but brief, lymphoid expansion with a very low ALC.
Group B had the best survival rate—86%—compared to 67% in group A and 30% in group C. Relapse rates between groups A and B were similar, at 33% and 29%, respectively, while group C experienced a 90% relapse rate.
GVHD occurred in 67% of patients in group A, 43% in group B, and 10% in group C. And adoptive immunotherapy with donor cell infusions was required for 13% of patients in group A, 21% in group B, and 70% in group C.
“Our goal is to use this data to develop models that can predict complications from stem cell transplantation,” Dr Toor said. “Then, we may be able to intervene at key points in time with appropriate clinical treatments that will make the most positive impact on patients’ outcomes.”
Photo courtesy of VCU
Massey Cancer Center
Results of a retrospective study suggest lymphocyte recovery is associated with outcomes after allogeneic hematopoietic stem cell transplant (HSCT).
Researchers found that, after transplant, lymphocyte recovery occurred in 1 of 3 general patterns.
And these patterns were associated with the rate of survival, relapse, and graft-vs-host disease (GVHD), as well as the need for further donor immune cell infusions to treat the patients’ disease.
Amir Toor, MD, of VCU Massey Cancer Center in Richmond, Virginia, and his colleagues reported these findings in Biology of Blood & Marrow Transplantation.
The team had examined lymphocyte recovery and clinical outcome data from a phase 2 trial (NCT00709592) of 41 patients who received an HSCT from a related or unrelated donor.
As part of the trial protocol, the patients underwent low-dose radiation therapy and received 1 of 2 different doses of anti-thymocyte globulin as GVHD prophylaxis.
The researchers found that, after transplant, lymphocyte recovery followed 1 of 3 general patterns that correlated with patient outcomes.
“We began considering lymphocyte reconstitution following stem cell transplantation as similar to population growth models,” Dr Toor explained. “So we graphed the lymphocyte counts of our patients at various times following their transplant as a logistic function and observed distinct patterns that correlated with clinical outcomes.”
Patients in group A experienced fast, early lymphoid expansion, culminating in a high absolute lymphoid count (ALC) within 2 months of HSCT. Group B experienced a slower, but steady, lymphoid expansion that peaked much later than group A with a lower ALC. Group C experienced very poor lymphocyte recovery that demonstrated an early, but brief, lymphoid expansion with a very low ALC.
Group B had the best survival rate—86%—compared to 67% in group A and 30% in group C. Relapse rates between groups A and B were similar, at 33% and 29%, respectively, while group C experienced a 90% relapse rate.
GVHD occurred in 67% of patients in group A, 43% in group B, and 10% in group C. And adoptive immunotherapy with donor cell infusions was required for 13% of patients in group A, 21% in group B, and 70% in group C.
“Our goal is to use this data to develop models that can predict complications from stem cell transplantation,” Dr Toor said. “Then, we may be able to intervene at key points in time with appropriate clinical treatments that will make the most positive impact on patients’ outcomes.”