Predictive Value Of Autograft Absolute Monocyte Count In Patients Underwent Autologous Stem Cell Transplantation

Abstract

Background: Autologous stem cell transplantation (ASCT), following intensive chemotherapy, is a common treatment for patients with hematologic cancers such as lymphoma and multiple myeloma. The Autograft Absolute Lymphocyte Count (A-ALC) has been recognized as an important prognostic marker for survival in patients undergoing ASCT. In this article, we studied the predictive value of Absolute Monocyte count (A-AMC) in engraftment kinetics and survival in patients who underwent ASCT. Methods: This is a prospective study applied to adult patients who underwent ASCT at the Oncology Centre, Mansoura University, Egypt within 2 years from June 2021 to June 2023. A-AMC was calculated and prognostic factors that may influence the course of the disease were chosen. Results: There were 49 patients, 21 patients (42.9%) were male and 28 patients (57.1%) were female with a median age of 42 (19-64). 20 patients (40.8%), 16 patients (32.7%) and 13 patients (26.5%) were diagnosed with multiple myeloma, Hodgkin lymphoma and Non- Hodgkin lymphoma respectively. Patients underwent ASCT after the first complete response or the second complete response according to the type of disease. The median cut-off value of A-AMC was 60.7. High A-AMC was associated with rapid platelet engraftment with a mean of 12.25 days vs. 15.25 days with low A-AMC which is statistically significant (P-value 0.029). Also, high A-AMC was associated with shorter hospital stay duration with a mean of 14.96 days vs. 18 days with low A-AMC which is also statistically significant (P-value 0.033). On the other hand, 2 years disease-free survival (DFS) was about 82% with low A-AMC vs. 58% with high A-AMC in lymphoma that was borderline statistically significant (P-value 0.05). 2 years progression-free survival (PFS) was 100% with low A-AMC vs. 80% with high A-AMC in MM that was not statistically significant (P -value 0.18) as shown in Figure 1 and Figure 2. Conclusion: A-AMC was identified as a useful prognostic factor for platelet engraftment, hospital stay duration, DFS and PFS in patients who underwent ASCT.