Anu Partanen1, Antti Turunen1,2, Jaakko Valtola1, Marja Pyörälä1, Kaija Vasala3, Outi Kuittinen2,4,5, Hanne Kuitunen5, Karri Penttilä6,7, Leena Keskinen8, Taru Kuittinen1, Pentti Mäntymaa9, Jukka Pelkonen9,10, Ville Varmavuo11, Esa Jantunen1,2,12. 1. Department of Medicine, Kuopio University Hospital, Kuopio, Finland. 2. Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. 3. Department of Oncology, Central Hospital of Central Finland, Jyväskylä, Finland. 4. Department of Oncology, Kuopio University Hospital, Kuopio, Finland. 5. Department of Oncology, Oulu University Hospital, Oulu, Finland. 6. Department of Medicine, Central Hospital of Savonlinna, Savonlinna, Finland. 7. Finnish Medicines Agency, Kuopio, Finland. 8. Department of Oncology, Tampere University Hospital, Tampere, Finland. 9. Eastern Finland Laboratory Centre, Kuopio, Finland. 10. Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland. 11. Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland. 12. Department of Medicine, Hospital District of North Karelia, Joensuu, Finland.
Abstract
BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is a common indication for autologous stem cell transplantation (auto-SCT). STUDY DESIGN AND METHODS: This prospective noninterventional study aimed to evaluate the impact of mobilization characteristics and graft cellular content on hematologic recovery and outcome after auto-SCT among 68 patients with DLBCL. RESULTS: Better mobilization capacity as manifested by blood CD34+ cell count >32 × 106 /L and CD34+ cell yield of the first apheresis >2.75 × 106 /kg correlated with faster neutrophil (P = .005 and P = .017) and platelet (P = .002 and P < .001) recovery. A higher number of infused CD34+ cells (> 2.65 × 106 /kg) was associated with better 5-year overall survival (OS; 95% vs 67%, P = .012). The graft CD34+ CD133+ CD38- cell count >0.07 × 106 /kg was predictive of better 5-year OS (87% vs 63%; P = .008) and higher graft CD3+ cell count (>23.1 × 106 /kg) correlated also with better 5-year OS (80% vs 40%, P = .008). In multivariate analysis only disease status of CR I at auto-SCT was associated with better progression-free survival (P = .014) and OS (P = .039). CONCLUSION: The mobilization capacity of CD34+ cells impacted on early hematologic recovery in patients with DLBCL after auto-SCT. Higher graft CD34+ cell count and both CD34+ CD133+ CD38- and CD3+ cells were also associated with better OS. The effect of optimal graft cellular composition on outcome in DLBCL should be evaluated in a randomized study.
BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is a common indication for autologous stem cell transplantation (auto-SCT). STUDY DESIGN AND METHODS: This prospective noninterventional study aimed to evaluate the impact of mobilization characteristics and graft cellular content on hematologic recovery and outcome after auto-SCT among 68 patients with DLBCL. RESULTS: Better mobilization capacity as manifested by blood CD34+ cell count >32 × 106 /L and CD34+ cell yield of the first apheresis >2.75 × 106 /kg correlated with faster neutrophil (P = .005 and P = .017) and platelet (P = .002 and P < .001) recovery. A higher number of infused CD34+ cells (> 2.65 × 106 /kg) was associated with better 5-year overall survival (OS; 95% vs 67%, P = .012). The graft CD34+ CD133+ CD38- cell count >0.07 × 106 /kg was predictive of better 5-year OS (87% vs 63%; P = .008) and higher graft CD3+ cell count (>23.1 × 106 /kg) correlated also with better 5-year OS (80% vs 40%, P = .008). In multivariate analysis only disease status of CR I at auto-SCT was associated with better progression-free survival (P = .014) and OS (P = .039). CONCLUSION: The mobilization capacity of CD34+ cells impacted on early hematologic recovery in patients with DLBCL after auto-SCT. Higher graft CD34+ cell count and both CD34+ CD133+ CD38- and CD3+ cells were also associated with better OS. The effect of optimal graft cellular composition on outcome in DLBCL should be evaluated in a randomized study.
Authors: Luis F Porrata; David J Inwards; Stephen M Ansell; Ivana N Micallef; Patrick B Johnston; Jose C Villasboas; Jonas Paludo; Svetomir N Markovic Journal: EJHaem Date: 2022-02-24
Authors: Anu Partanen; Outi Kuittinen; Antti Turunen; Jaakko Valtola; Marja Pyorala; Hanne Kuitunen; Kaija Vasala; Taru Kuittinen; Pentti Mantymaa; Jukka Pelkonen; Esa Jantunen; Ville Varmavuo Journal: J Hematol Date: 2021-12-13