1. Autograft cellular composition and outcome in myeloma patients:results of the prospective multicenter GOA study
- Author
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Turunen, A. (Antti), Silvennoinen, R. (Raija), Partanen, A. (Anu), Valtola, J. (Jaakko), Siitonen, T. (Timo), Putkonen, M. (Mervi), Sankelo, M. (Marja), Pyörälä, M. (Marja), Kuittinen, T. (Taru), Penttilä, K. (Karri), Sikiö, A. (Anu), Savolainen, E.-R. (Eeva-Riitta), Mäntymaa, P. (Pentti), Pelkonen, J. (Jukka), Varmavuo, V. (Ville), and Jantunen, E. (Esa)
- Subjects
autograft cellular composition ,surgical procedures, operative ,autologous stem cell transplantation ,myeloma ,T lymphocytes ,outcome ,hematologic recovery ,NK cells ,CD34+ cells - Abstract
Background: Autologous stem cell transplantation (auto-SCT) is a widely used treatment option in multiple myeloma (MM) patients. The optimal graft cellular composition is not known. Study design and methods: Autograft cellular composition was analyzed after freezing by flow cytometry in 127 MM patients participating in a prospective multicenter study. The impact of graft cellular composition on hematologic recovery and outcome after auto-SCT was evaluated. Results: A higher graft CD34⁺ cell content predicted faster platelet recovery after auto-SCT in both the short and long term. In patients with standard-risk cytogenetics, a higher graft CD34⁺ count (0.065 × 10⁶/kg, p = 0.009) and NK cell count (%gt;2.5 × 10⁶/kg, p = 0.026), lenalidomide maintenance and standard-risk cytogenetics predicted better PFS. In contrast, a higher CD34+ count (>2.5 × 10⁶/kg, p = 0.015) predicted worse PFS. A very low CD3⁺ cell count (≤20 × 10⁶/kg, p = 0.001) in the infused graft and high-risk cytogenetics remained predictive of worse OS. Conclusions: Autograft cellular composition may impact outcome in MM patients after auto-SCT. More studies are needed to define optimal graft composition.
- Published
- 2021