1. Mobilization characteristics, blood graft composition, and outcome in diffuse large <scp>B‐cell</scp> lymphoma after <scp>autologous</scp> stem cell transplantation: Results from the prospective multicenter <scp>GOA</scp> study
- Author
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Jaakko Valtola, Leena Keskinen, Ville Varmavuo, Esa Jantunen, Jukka Pelkonen, Hanne Kuitunen, Karri Penttilä, Antti Turunen, Marja Pyörälä, Anu Partanen, Taru Kuittinen, Pentti Mäntymaa, Kaija Vasala, and Outi Kuittinen
- Subjects
Male ,CD3 Complex ,Cell ,CD34 ,Antigens, CD34 ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,CD38 ,Gastroenterology ,Polyethylene Glycols ,0302 clinical medicine ,Autologous stem-cell transplantation ,immune system diseases ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,Immunology and Allergy ,Platelet ,Prospective Studies ,Melphalan ,Etoposide ,biology ,Graft Survival ,Remission Induction ,Cytarabine ,Hematology ,Middle Aged ,Combined Modality Therapy ,Hematopoietic Stem Cell Mobilization ,Progression-Free Survival ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Lymphoma, Large B-Cell, Diffuse ,Adult ,medicine.medical_specialty ,Filgrastim ,CD3 ,Immunology ,Transplantation, Autologous ,Disease-Free Survival ,Young Adult ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Cyclophosphamide ,Aged ,Febrile Neutropenia ,Peripheral Blood Stem Cell Transplantation ,business.industry ,Hematopoietic Stem Cells ,medicine.disease ,Carmustine ,Blood Cell Count ,Lymphoma ,biology.protein ,business ,Diffuse large B-cell lymphoma ,Follow-Up Studies ,030215 immunology - 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 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.
- Published
- 2020