Clinical prognostic significance of early lymphocyte recovery after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia

Objective To analyze the clinical significance of early lymphocyte recovery after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute myeloid leukemia. Methods The clinical data of 89 patients with acute myeloid leukemia undergoing allo-HSCT were retrospectively analyzed. The absolute lymphocyte count at Day 21 (ALC21) after allo-HSCT was used for representing the recovery rate of lymphocyte. And the effects of ALC21 on disease relapse, overall survival (OS), disease-free survival (DFS) and other parameters were analyzed. Results The recurrent rate of ALC21 ≥0.5×109/L group (high ALC21 group) was significantly lower than that of ALC21 <0.5×109/L group (low ALC21 group)(19.6 % vs 48.5 %, P=0.004). The 2-year OS and DFS of high ALC21 group spiked markedly as compared with low ALC21 group [(74.0±6.0 % vs (46.5±9.5) %, P=0.002], [(70.5±6.2) % vs (44.9±9.3) %, P=0.009] while viral infection rate declined markedly (37.5 % vs 60.6 %, P=0.035). However, non-recurrence mortality (NRM), acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) (P=0.556) were not elevated in high ALC21 group as compared with low ALC21 group (P=0.584, P=0.08, P=0.556). Conclusions Early lymphocyte recovery after in acute myeloid leukemia patients has significant early predictive value for recurrence and long-term prognosis after allo-HSCT. Key words: Allogeneic hematopoietic stem cell transplantation; Acute leukemia; lymphocyte