The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Naseema Gangat - One of the best experts on this subject based on the ideXlab platform.
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Prognostic relevance of lymphocytopenia, Monocytopenia and lymphocyte-to-monocyte ratio in primary myelodysplastic syndromes: a single center experience in 889 patients
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Current prognostic models for myelodysplastic syndromes (MDS), including the Revised International Prognostic Scoring System (IPSS-R), do not account for host immunity. We retrospectively examined the prognostic relevance of Monocytopenia, lymphocytopenia and lymphocyte-to-monocyte ratio (LMR) in a cohort of 889 patients with primary MDS. After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformation were documented. In univariate analysis, subnormal absolute lymphocyte count (ALC) <0.9 × 109/l; P=0.001), ALC<1.2 × 109/l (P=0.0002), subnormal absolute monocyte count (AMC) <0.3 × 109/l (P=0.0003), LMR (P⩽0.0001) and LMR⩾5 (P=0.03) were all associated with inferior overall survival. In multivariable analysis that included other risk factors, significance was retained for LMR (P=0.02) and became borderline for ALC <1.2 × 109/l (P=0.06). Analysis in the context of IPSS-R resulted in P-values of 0.06 for ALC<1.2 × 109/l, 0.7 for Monocytopenia and 0.2 for LMR. Leukemia-free survival was not affected by ALC, AMC or LMR. The observations from the current study suggest a possible detrimental role for altered host immunity in primary MDS, which might partly explain the therapeutic benefit of immune-directed therapy, including the use of immune modulators; however, IPSS-R-independent prognostic value for either ALC or AMC was limited.
-
prognostic relevance of Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes
Blood, 2016Co-Authors: Lyla Saeed, Mrinal M Patnaik, Naseema Gangat, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Ayalew TefferiAbstract:Abstract Background We have previously shown an independent adverse prognostic effect of lymphopenia (absolute lymphocyte count Methods We retrospectively recruited 889 consecutive patients with primary MDS who were untreated at the time of referral to our institution and in whom absolute monocyte count (AMC) and absolute lymphocyte count (ALC) at time of referral were documented. The diagnosis of MDS and leukemic transformation (LT) was made according to WHO criteria (Blood. 2009;114:937). Complete follow-up information was updated in January 2015. For the purposes of the current study, Monocytopenia was defined as AMC below the lower limit of the institutional normal range, which was 0.3 to 0.9 x 10(9)/L. Comparisons of survival and other clinical parameters were performed between i) patients with and without Monocytopenia and ii) patients with and without LMR ≥5. Conventional methods were used for statistical analysis. Results Patient characteristics: Median (range) values for the 889 study patients (69% males) included: age 72 (18-98), hemoglobin 9.6 g/dL (5.4-15.7), leukocyte count 3.4 x 10(9)/L (0.4-35), platelet count 106 x 10(9)/L (2-1804), circulating blasts 0% (0-18), bone marrow blasts 3% (0-19) and absolute lymphocyte count (ALC) 1.2 x 10(9)/L (.02-8.9). Transfusion need was documented in 33% of patients and abnormal cytogenetics in 49%. Risk stratification by the revised international prognostic scoring system (IPSS-R) was very high in 11%, high in 16%, intermediate in 21%, low in 36% and very low in 16%. The median (range) AMC for the entire study population of 889 patients was 0.22 x 10(9)/L (0.0-1.8).The number of patients with subnormal AMC was 539 (61%). After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformations were documented. Comparison of patients stratified by absolute monocyte count and LMR Compared to patients with AMC >0.3 x 10(9)/L, MDS patients with Monocytopenia displayed younger age (p In univariate analysis, lower AMC was associated with inferior survival (p=0.002); significance was even more apparent when comparing patients with and without Monocytopenia (p=0.0003; HR 1.3, 95% CI 1.1-1.5). Similarly, there was significant association between LMR and survival (p Conclusions Monocytopenia in MDS clusters with adverse disease features and both Monocytopenia and higher LMR were associated with poor survival. Despite the display of prognostic independence from each other and other risk factors considered individually, the survival impact of neither Monocytopenia nor LMR was found to be independent of IPSS-R. Disclosures Al-Kali: Novartis: Research Funding; Celgene: Research Funding.
Mrinal M Patnaik - One of the best experts on this subject based on the ideXlab platform.
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Prognostic relevance of lymphocytopenia, Monocytopenia and lymphocyte-to-monocyte ratio in primary myelodysplastic syndromes: a single center experience in 889 patients
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Current prognostic models for myelodysplastic syndromes (MDS), including the Revised International Prognostic Scoring System (IPSS-R), do not account for host immunity. We retrospectively examined the prognostic relevance of Monocytopenia, lymphocytopenia and lymphocyte-to-monocyte ratio (LMR) in a cohort of 889 patients with primary MDS. After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformation were documented. In univariate analysis, subnormal absolute lymphocyte count (ALC) <0.9 × 109/l; P=0.001), ALC<1.2 × 109/l (P=0.0002), subnormal absolute monocyte count (AMC) <0.3 × 109/l (P=0.0003), LMR (P⩽0.0001) and LMR⩾5 (P=0.03) were all associated with inferior overall survival. In multivariable analysis that included other risk factors, significance was retained for LMR (P=0.02) and became borderline for ALC <1.2 × 109/l (P=0.06). Analysis in the context of IPSS-R resulted in P-values of 0.06 for ALC<1.2 × 109/l, 0.7 for Monocytopenia and 0.2 for LMR. Leukemia-free survival was not affected by ALC, AMC or LMR. The observations from the current study suggest a possible detrimental role for altered host immunity in primary MDS, which might partly explain the therapeutic benefit of immune-directed therapy, including the use of immune modulators; however, IPSS-R-independent prognostic value for either ALC or AMC was limited.
-
prognostic relevance of Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes
Blood, 2016Co-Authors: Lyla Saeed, Mrinal M Patnaik, Naseema Gangat, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Ayalew TefferiAbstract:Abstract Background We have previously shown an independent adverse prognostic effect of lymphopenia (absolute lymphocyte count Methods We retrospectively recruited 889 consecutive patients with primary MDS who were untreated at the time of referral to our institution and in whom absolute monocyte count (AMC) and absolute lymphocyte count (ALC) at time of referral were documented. The diagnosis of MDS and leukemic transformation (LT) was made according to WHO criteria (Blood. 2009;114:937). Complete follow-up information was updated in January 2015. For the purposes of the current study, Monocytopenia was defined as AMC below the lower limit of the institutional normal range, which was 0.3 to 0.9 x 10(9)/L. Comparisons of survival and other clinical parameters were performed between i) patients with and without Monocytopenia and ii) patients with and without LMR ≥5. Conventional methods were used for statistical analysis. Results Patient characteristics: Median (range) values for the 889 study patients (69% males) included: age 72 (18-98), hemoglobin 9.6 g/dL (5.4-15.7), leukocyte count 3.4 x 10(9)/L (0.4-35), platelet count 106 x 10(9)/L (2-1804), circulating blasts 0% (0-18), bone marrow blasts 3% (0-19) and absolute lymphocyte count (ALC) 1.2 x 10(9)/L (.02-8.9). Transfusion need was documented in 33% of patients and abnormal cytogenetics in 49%. Risk stratification by the revised international prognostic scoring system (IPSS-R) was very high in 11%, high in 16%, intermediate in 21%, low in 36% and very low in 16%. The median (range) AMC for the entire study population of 889 patients was 0.22 x 10(9)/L (0.0-1.8).The number of patients with subnormal AMC was 539 (61%). After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformations were documented. Comparison of patients stratified by absolute monocyte count and LMR Compared to patients with AMC >0.3 x 10(9)/L, MDS patients with Monocytopenia displayed younger age (p In univariate analysis, lower AMC was associated with inferior survival (p=0.002); significance was even more apparent when comparing patients with and without Monocytopenia (p=0.0003; HR 1.3, 95% CI 1.1-1.5). Similarly, there was significant association between LMR and survival (p Conclusions Monocytopenia in MDS clusters with adverse disease features and both Monocytopenia and higher LMR were associated with poor survival. Despite the display of prognostic independence from each other and other risk factors considered individually, the survival impact of neither Monocytopenia nor LMR was found to be independent of IPSS-R. Disclosures Al-Kali: Novartis: Research Funding; Celgene: Research Funding.
-
Spectrum of myeloid neoplasms and immune deficiency associated with germline GATA2 mutations
Cancer Medicine, 2015Co-Authors: Muhammad A. Mir, Amy P. Hsu, Samith T. Kochuparambil, Amie E. Jackson, Vilmarie Rodriguez, Matthew Howard, Roshini S Abraham, Steven M. Holland, Mrinal M PatnaikAbstract:Guanine-adenine-thymine-adenine 2 (GATA2) mutated disorders include the recently described MonoMAC syndrome (Monocytopenia and Mycobacterium avium complex infections), DCML (dendritic cell, monocyte, and lymphocyte deficiency), familial MDS/AML (myelodysplastic syndrome/acute myeloid leukemia) (myeloid neoplasms), congenital neutropenia, congenital lymphedema (Emberger's syndrome), sensorineural deafness, viral warts, and a spectrum of aggressive infections seen across all age groups. While considerable efforts have been made to identify the mutations that characterize this disorder, pathogenesis remains a work in progress with less than 100 patients described in current literature. Varying clinical presentations offer diagnostic challenges. Allogeneic stem cell transplant remains the treatment of choice. Morbidity, mortality, and social costs due to the familial nature of the disease are considerable. We describe our experience with the disorder in three affected families and a comprehensive review of current literature.
-
impact of clinical factors and allograft leukocyte content on post transplant lymphopenia Monocytopenia and survival in patients undergoing allogeneic peripheral blood haematopoietic cell transplant
BMC Hematology, 2014Co-Authors: Mary Thoma, Mrinal M Patnaik, Mark R. Litzow, Jennifer Glejf, Eapen K Jacob, Tanya J Huneke, Lori Decook, Nicci D Johnson, William J Hogan, Laura F NewellAbstract:We have previously shown that lymphopenia and Monocytopenia at 2–3 months post-allogeneic haematopoietic cell transplant (HCT) is associated with poor survival in recipients of both myeloablative and reduced intensity conditioning regimens. It is not known whether the graft leukocyte content has a role in early lymphocyte and monocyte recovery following allogeneic T-cell replete peripheral blood HCT. Haematologic recovery data, including absolute lymphocyte and monocyte counts (ALC and AMC, respectively) at day +15, +30, +60, and +100, and outcomes data were pooled from two prior independent cohorts, and parameters were correlated with leukocyte graft content in those individuals receiving peripheral blood progenitor cell grafts. 216 consecutive patients from 2001–2010 were included in the analysis. Neither infused allograft lymphocyte, monocyte, granulocyte, nor CD34+ cell number per kilogram recipient body weight correlated with haematologic recovery parameters or overall survival in this cohort. Prognostic factors for overall survival based on multivariate analysis were as expected from the results of the previous independent cohorts and included severity of chronic GVHD (p 0.3 x 109 cells/L (p = 0.0015), and day +100 ALC > 0.3 x 109 cells/L (p < 0.001). Low monocyte and lymphocyte counts at the day +60 and day +100 time points were significantly associated with acute GVHD and/or CMV viraemia. This study suggests that graft cell count does not influence post-transplant monocyte and lymphocyte recovery following T-cell replete allogeneic peripheral blood HCT. Post-transplant complications such as acute GVHD and/or CMV viraemia negatively influenced monocyte and lymphocyte recovery, and hence the survival. Further studies aimed at understanding the mechanisms behind sustained lymphopenia and Monocytopenia post-transplant are needed.
Lyla Saeed - One of the best experts on this subject based on the ideXlab platform.
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Prognostic relevance of lymphocytopenia, Monocytopenia and lymphocyte-to-monocyte ratio in primary myelodysplastic syndromes: a single center experience in 889 patients
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Current prognostic models for myelodysplastic syndromes (MDS), including the Revised International Prognostic Scoring System (IPSS-R), do not account for host immunity. We retrospectively examined the prognostic relevance of Monocytopenia, lymphocytopenia and lymphocyte-to-monocyte ratio (LMR) in a cohort of 889 patients with primary MDS. After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformation were documented. In univariate analysis, subnormal absolute lymphocyte count (ALC) <0.9 × 109/l; P=0.001), ALC<1.2 × 109/l (P=0.0002), subnormal absolute monocyte count (AMC) <0.3 × 109/l (P=0.0003), LMR (P⩽0.0001) and LMR⩾5 (P=0.03) were all associated with inferior overall survival. In multivariable analysis that included other risk factors, significance was retained for LMR (P=0.02) and became borderline for ALC <1.2 × 109/l (P=0.06). Analysis in the context of IPSS-R resulted in P-values of 0.06 for ALC<1.2 × 109/l, 0.7 for Monocytopenia and 0.2 for LMR. Leukemia-free survival was not affected by ALC, AMC or LMR. The observations from the current study suggest a possible detrimental role for altered host immunity in primary MDS, which might partly explain the therapeutic benefit of immune-directed therapy, including the use of immune modulators; however, IPSS-R-independent prognostic value for either ALC or AMC was limited.
-
prognostic relevance of Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes
Blood, 2016Co-Authors: Lyla Saeed, Mrinal M Patnaik, Naseema Gangat, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Ayalew TefferiAbstract:Abstract Background We have previously shown an independent adverse prognostic effect of lymphopenia (absolute lymphocyte count Methods We retrospectively recruited 889 consecutive patients with primary MDS who were untreated at the time of referral to our institution and in whom absolute monocyte count (AMC) and absolute lymphocyte count (ALC) at time of referral were documented. The diagnosis of MDS and leukemic transformation (LT) was made according to WHO criteria (Blood. 2009;114:937). Complete follow-up information was updated in January 2015. For the purposes of the current study, Monocytopenia was defined as AMC below the lower limit of the institutional normal range, which was 0.3 to 0.9 x 10(9)/L. Comparisons of survival and other clinical parameters were performed between i) patients with and without Monocytopenia and ii) patients with and without LMR ≥5. Conventional methods were used for statistical analysis. Results Patient characteristics: Median (range) values for the 889 study patients (69% males) included: age 72 (18-98), hemoglobin 9.6 g/dL (5.4-15.7), leukocyte count 3.4 x 10(9)/L (0.4-35), platelet count 106 x 10(9)/L (2-1804), circulating blasts 0% (0-18), bone marrow blasts 3% (0-19) and absolute lymphocyte count (ALC) 1.2 x 10(9)/L (.02-8.9). Transfusion need was documented in 33% of patients and abnormal cytogenetics in 49%. Risk stratification by the revised international prognostic scoring system (IPSS-R) was very high in 11%, high in 16%, intermediate in 21%, low in 36% and very low in 16%. The median (range) AMC for the entire study population of 889 patients was 0.22 x 10(9)/L (0.0-1.8).The number of patients with subnormal AMC was 539 (61%). After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformations were documented. Comparison of patients stratified by absolute monocyte count and LMR Compared to patients with AMC >0.3 x 10(9)/L, MDS patients with Monocytopenia displayed younger age (p In univariate analysis, lower AMC was associated with inferior survival (p=0.002); significance was even more apparent when comparing patients with and without Monocytopenia (p=0.0003; HR 1.3, 95% CI 1.1-1.5). Similarly, there was significant association between LMR and survival (p Conclusions Monocytopenia in MDS clusters with adverse disease features and both Monocytopenia and higher LMR were associated with poor survival. Despite the display of prognostic independence from each other and other risk factors considered individually, the survival impact of neither Monocytopenia nor LMR was found to be independent of IPSS-R. Disclosures Al-Kali: Novartis: Research Funding; Celgene: Research Funding.
Mark R. Litzow - One of the best experts on this subject based on the ideXlab platform.
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Prognostic relevance of lymphocytopenia, Monocytopenia and lymphocyte-to-monocyte ratio in primary myelodysplastic syndromes: a single center experience in 889 patients
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Current prognostic models for myelodysplastic syndromes (MDS), including the Revised International Prognostic Scoring System (IPSS-R), do not account for host immunity. We retrospectively examined the prognostic relevance of Monocytopenia, lymphocytopenia and lymphocyte-to-monocyte ratio (LMR) in a cohort of 889 patients with primary MDS. After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformation were documented. In univariate analysis, subnormal absolute lymphocyte count (ALC) <0.9 × 109/l; P=0.001), ALC<1.2 × 109/l (P=0.0002), subnormal absolute monocyte count (AMC) <0.3 × 109/l (P=0.0003), LMR (P⩽0.0001) and LMR⩾5 (P=0.03) were all associated with inferior overall survival. In multivariable analysis that included other risk factors, significance was retained for LMR (P=0.02) and became borderline for ALC <1.2 × 109/l (P=0.06). Analysis in the context of IPSS-R resulted in P-values of 0.06 for ALC<1.2 × 109/l, 0.7 for Monocytopenia and 0.2 for LMR. Leukemia-free survival was not affected by ALC, AMC or LMR. The observations from the current study suggest a possible detrimental role for altered host immunity in primary MDS, which might partly explain the therapeutic benefit of immune-directed therapy, including the use of immune modulators; however, IPSS-R-independent prognostic value for either ALC or AMC was limited.
-
prognostic relevance of Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes
Blood, 2016Co-Authors: Lyla Saeed, Mrinal M Patnaik, Naseema Gangat, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Ayalew TefferiAbstract:Abstract Background We have previously shown an independent adverse prognostic effect of lymphopenia (absolute lymphocyte count Methods We retrospectively recruited 889 consecutive patients with primary MDS who were untreated at the time of referral to our institution and in whom absolute monocyte count (AMC) and absolute lymphocyte count (ALC) at time of referral were documented. The diagnosis of MDS and leukemic transformation (LT) was made according to WHO criteria (Blood. 2009;114:937). Complete follow-up information was updated in January 2015. For the purposes of the current study, Monocytopenia was defined as AMC below the lower limit of the institutional normal range, which was 0.3 to 0.9 x 10(9)/L. Comparisons of survival and other clinical parameters were performed between i) patients with and without Monocytopenia and ii) patients with and without LMR ≥5. Conventional methods were used for statistical analysis. Results Patient characteristics: Median (range) values for the 889 study patients (69% males) included: age 72 (18-98), hemoglobin 9.6 g/dL (5.4-15.7), leukocyte count 3.4 x 10(9)/L (0.4-35), platelet count 106 x 10(9)/L (2-1804), circulating blasts 0% (0-18), bone marrow blasts 3% (0-19) and absolute lymphocyte count (ALC) 1.2 x 10(9)/L (.02-8.9). Transfusion need was documented in 33% of patients and abnormal cytogenetics in 49%. Risk stratification by the revised international prognostic scoring system (IPSS-R) was very high in 11%, high in 16%, intermediate in 21%, low in 36% and very low in 16%. The median (range) AMC for the entire study population of 889 patients was 0.22 x 10(9)/L (0.0-1.8).The number of patients with subnormal AMC was 539 (61%). After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformations were documented. Comparison of patients stratified by absolute monocyte count and LMR Compared to patients with AMC >0.3 x 10(9)/L, MDS patients with Monocytopenia displayed younger age (p In univariate analysis, lower AMC was associated with inferior survival (p=0.002); significance was even more apparent when comparing patients with and without Monocytopenia (p=0.0003; HR 1.3, 95% CI 1.1-1.5). Similarly, there was significant association between LMR and survival (p Conclusions Monocytopenia in MDS clusters with adverse disease features and both Monocytopenia and higher LMR were associated with poor survival. Despite the display of prognostic independence from each other and other risk factors considered individually, the survival impact of neither Monocytopenia nor LMR was found to be independent of IPSS-R. Disclosures Al-Kali: Novartis: Research Funding; Celgene: Research Funding.
-
impact of clinical factors and allograft leukocyte content on post transplant lymphopenia Monocytopenia and survival in patients undergoing allogeneic peripheral blood haematopoietic cell transplant
BMC Hematology, 2014Co-Authors: Mary Thoma, Mrinal M Patnaik, Mark R. Litzow, Jennifer Glejf, Eapen K Jacob, Tanya J Huneke, Lori Decook, Nicci D Johnson, William J Hogan, Laura F NewellAbstract:We have previously shown that lymphopenia and Monocytopenia at 2–3 months post-allogeneic haematopoietic cell transplant (HCT) is associated with poor survival in recipients of both myeloablative and reduced intensity conditioning regimens. It is not known whether the graft leukocyte content has a role in early lymphocyte and monocyte recovery following allogeneic T-cell replete peripheral blood HCT. Haematologic recovery data, including absolute lymphocyte and monocyte counts (ALC and AMC, respectively) at day +15, +30, +60, and +100, and outcomes data were pooled from two prior independent cohorts, and parameters were correlated with leukocyte graft content in those individuals receiving peripheral blood progenitor cell grafts. 216 consecutive patients from 2001–2010 were included in the analysis. Neither infused allograft lymphocyte, monocyte, granulocyte, nor CD34+ cell number per kilogram recipient body weight correlated with haematologic recovery parameters or overall survival in this cohort. Prognostic factors for overall survival based on multivariate analysis were as expected from the results of the previous independent cohorts and included severity of chronic GVHD (p 0.3 x 109 cells/L (p = 0.0015), and day +100 ALC > 0.3 x 109 cells/L (p < 0.001). Low monocyte and lymphocyte counts at the day +60 and day +100 time points were significantly associated with acute GVHD and/or CMV viraemia. This study suggests that graft cell count does not influence post-transplant monocyte and lymphocyte recovery following T-cell replete allogeneic peripheral blood HCT. Post-transplant complications such as acute GVHD and/or CMV viraemia negatively influenced monocyte and lymphocyte recovery, and hence the survival. Further studies aimed at understanding the mechanisms behind sustained lymphopenia and Monocytopenia post-transplant are needed.
Luis F Porrata - One of the best experts on this subject based on the ideXlab platform.
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Prognostic relevance of lymphocytopenia, Monocytopenia and lymphocyte-to-monocyte ratio in primary myelodysplastic syndromes: a single center experience in 889 patients
-
prognostic relevance of lymphocytopenia Monocytopenia and lymphocyte to monocyte ratio in primary myelodysplastic syndromes a single center experience in 889 patients
Blood Cancer Journal, 2017Co-Authors: Lyla Saeed, Mrinal M Patnaik, Aref Alkali, Kebede H. Begna, Mark R. Litzow, Luis F Porrata, Rhett P Ketterling, Curtis A. Hanson, Animesh Pardanani, Naseema GangatAbstract:Current prognostic models for myelodysplastic syndromes (MDS), including the Revised International Prognostic Scoring System (IPSS-R), do not account for host immunity. We retrospectively examined the prognostic relevance of Monocytopenia, lymphocytopenia and lymphocyte-to-monocyte ratio (LMR) in a cohort of 889 patients with primary MDS. After a median follow-up of 27 months, 712 (80%) deaths and 116 (13%) leukemic transformation were documented. In univariate analysis, subnormal absolute lymphocyte count (ALC) <0.9 × 109/l; P=0.001), ALC<1.2 × 109/l (P=0.0002), subnormal absolute monocyte count (AMC) <0.3 × 109/l (P=0.0003), LMR (P⩽0.0001) and LMR⩾5 (P=0.03) were all associated with inferior overall survival. In multivariable analysis that included other risk factors, significance was retained for LMR (P=0.02) and became borderline for ALC <1.2 × 109/l (P=0.06). Analysis in the context of IPSS-R resulted in P-values of 0.06 for ALC<1.2 × 109/l, 0.7 for Monocytopenia and 0.2 for LMR. Leukemia-free survival was not affected by ALC, AMC or LMR. The observations from the current study suggest a possible detrimental role for altered host immunity in primary MDS, which might partly explain the therapeutic benefit of immune-directed therapy, including the use of immune modulators; however, IPSS-R-independent prognostic value for either ALC or AMC was limited.