Lymphoma Clinical Trial
Official title:
Higher Infused Lymphocyte Counts Improve Antibody Response to Immunization After Autologous Stem Cell Transplantation
The purpose of this study is to determine if higher absolute lymphocyte count in the infused stem cell autograft (A-ALC) will lead to an improved antibody response to post-transplant immunization with Pneumococcal Conjugate Vaccine and permit effective immunization at 6 months post-transplant in lymphoma patients receiving Autologous Peripheral Blood Stem Cell Transplantation.
Infectious diseases remain a leading cause of morbidity and mortality in patients who receive
high-dose chemotherapy followed by Autologous Peripheral Blood Stem Cell Transplantation
(APBSCT). Infectious disease complications of transplantation might be reduced by effective
post-transplant immunization but reconstitution of the immune system may take months to years
after transplantation and responses to immunization are often attenuated in this setting.
Correlates of improved immune reconstitution and response to immunization after
transplantation would be important to identify. It has been recently shown that higher
absolute lymphocyte count in the infused stem cell autograft (A-ALC) and higher ALC at day
+15 after stem cell infusion (ALC-15) are independently associated with improved overall
survival after APBSCT. The mechanism of this association is unclear, but this finding
suggests that improved immune responses to immunization might also be achieved with this
approach making it possible to immunize at 6 months instead of at one year. This hypothesis
has never been evaluated.
Survival following APBSCT is improved with a higher A-ALC and ALC-15. It is postulated that
the higher lymphocyte numbers correlate with improved immune surveillance and destruction of
minimal residual disease. Thus, one must consider the probability higher A-ALC will confer
improved response to T-cell dependent immunization early after transplant.
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