Clinical impact of early recovery of peripheral blood absolute lymphocyte count after frontline autologous stem cell transplantation for diffuse large B‐cell lymphoma

We conducted a retrospective study to evaluate the clinical impact of an early recovery of posttransplant absolute lymphocyte count (ALC) on the outcome of frontline autologous stem cell transplantation (ASCT) for diffuse large B‐cell lymphoma (DLBCL). We reviewed 65 DLBCL patients who underwent frontline ASCT after primary chemotherapy based on cyclophosphamide, doxorubicin, vincristine, and prednisone. A receiver operating characteristic analysis was performed to determine the optimal cut point (0.4 × 10 9 /L) for an ALC at 15 days after ASCT (ALC‐15). Both event‐free survival and overall survival rates of the higher‐ALC‐15 group were significantly better than those of the lower‐ALC‐15 group (event‐free survival, P  = .008; overall survival, P  = .013). The infused CD34 + cell count was significantly associated with the recovery of ALC‐15 (>0.4 × 10 9 /L) after ASCT ( P  = .028). A multivariate analysis confirmed that a higher infused CD34 + cell dose (>5.0 × 10 6  cells/kg) was an independent factor affecting an early recovery of ALC after ASCT (odds ratio, 4.145; 95% confidence interval, 1.106‐15.528; P  = .035). In conclusion, an early recovery of ALC after ASCT can be regarded as a good prognostic marker in patients with DLBCL who have undergone frontline ASCT. We found that the infused CD34 + cell dose for ASCT was associated with the recovery of ALC.