Damlaj M, Ghazi S, Mashaqbeh W, Gmati G, Salama H, Abuelgasim KA, Rather M, Hajeer A, Al-Zahrani M, Jazieh AR, Hejazi A, Al Askar A. Lymphocyte recovery is an independent predictor of relapse in allogeneic hematopoietic cell transplantation recipients for acute leukemia. World J Transplant 2017; 7(4): 235-242 [PMID: 28900606 DOI: 10.5500/wjt.v7.i4.235]
Corresponding Author of This Article
Moussab Damlaj, MD, FRCPC, FACP, Division of Hematology and HSCT, Department of Oncology, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. damlajmo@ngha.med.sa
Research Domain of This Article
Transplantation
Article-Type of This Article
Observational Study
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Damlaj M, Ghazi S, Mashaqbeh W, Gmati G, Salama H, Abuelgasim KA, Rather M, Hajeer A, Al-Zahrani M, Jazieh AR, Hejazi A, Al Askar A. Lymphocyte recovery is an independent predictor of relapse in allogeneic hematopoietic cell transplantation recipients for acute leukemia. World J Transplant 2017; 7(4): 235-242 [PMID: 28900606 DOI: 10.5500/wjt.v7.i4.235]
World J Transplant. Aug 24, 2017; 7(4): 235-242 Published online Aug 24, 2017. doi: 10.5500/wjt.v7.i4.235
Lymphocyte recovery is an independent predictor of relapse in allogeneic hematopoietic cell transplantation recipients for acute leukemia
Moussab Damlaj, Samer Ghazi, Walid Mashaqbeh, Gamal Gmati, Hend Salama, Khadega A Abuelgasim, Mushtaq Rather, Ali Hajeer, Mohsen Al-Zahrani, Abdul-Rahman Jazieh, Ayman Hejazi, Ahmad Al Askar
Moussab Damlaj, Samer Ghazi, Walid Mashaqbeh, Gamal Gmati, Hend Salama, Khadega A Abuelgasim, Mushtaq Rather, Mohsen Al-Zahrani, Abdul-Rahman Jazieh, Ayman Hejazi, Ahmad Al Askar, Division of Hematology and HSCT, Department of Oncology, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia
Moussab Damlaj, Samer Ghazi, Walid Mashaqbeh, Gamal Gmati, Hend Salama, Khadega A Abuelgasim, Mushtaq Rather, Mohsen Al-Zahrani, Abdul-Rahman Jazieh, Ayman Hejazi, Ahmad Al Askar, King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia
Ali Hajeer, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
Author contributions: Damlaj M designed the study; Damlaj M, Ghazi S and Mashaqbeh W collected data; all authors analysed the data, provided patients, wrote and reviewed the manuscript, and approved final version of the manuscript.
Institutional review board statement: This study was approved by the institutional review board at King Abdulaziz Medical City (KAMC) - King Abdallah International Medical Research Center (KAIMRC).
Informed consent statement: The institutional review board waived informed consent due to the retrospective study design without patient contact or intervention; thus representing minimal risk study.
Conflict-of-interest statement: There are no conflicts of interest relevant to the conduct of this study.
Data sharing statement: There are no additional data available.
Correspondence to: Moussab Damlaj, MD, FRCPC, FACP, Division of Hematology and HSCT, Department of Oncology, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. damlajmo@ngha.med.sa
Fax: +966-11-8011111
Received: February 11, 2017 Peer-review started: February 15, 2017 First decision: March 27, 2017 Revised: July 6, 2017 Accepted: July 21, 2017 Article in press: July 24, 2017 Published online: August 24, 2017 Processing time: 191 Days and 14.8 Hours
Core Tip
Core tip: Disease relapse remains the most common cause of treatment failure after allogeneic hematopoietic stem cell transplantation for acute leukemia. Previous studies have identified that early lymphocyte recovery can be a surrogate of graft vs leukemia effect hence identifying high risk patients for relapse. However, published reports are heterogeneous with regards to timeline and magnitude of lymphocyte recovery. Using receiver operator characteristics with area under the curve, we identified that absolute lymphocyte count > 0.3 × 109/L at day 14 is associated with half the relapse risk which was statistically significant at the multivariable analysis. There was a trend towards improved progression free survival and overall survival for patients with early lymphocyte recovery. In conclusion, we observed that lymphocyte recovery is an independent predictor of relapse in allogeneic transplant recipients for acute leukemia. This would help identify high risk patients who may benefit from maintenance strategies post-transplant.
