Antti Samuli Turunen, Outi Kuittinen, Hanne Kuitunen, Kaija Vasala, Karri Penttilä, Minna Harmanen, Leena Keskinen, Pentti Mäntymaa, Jukka Pelkonen, Ville Varmavuo, Esa Jantunen, Anu Partanen
{"title":"CD34+细胞动员、自体移植物细胞组成和套细胞淋巴瘤患者的预后。","authors":"Antti Samuli Turunen, Outi Kuittinen, Hanne Kuitunen, Kaija Vasala, Karri Penttilä, Minna Harmanen, Leena Keskinen, Pentti Mäntymaa, Jukka Pelkonen, Ville Varmavuo, Esa Jantunen, Anu Partanen","doi":"10.1159/000531799","DOIUrl":null,"url":null,"abstract":"<p><strong>Backgound: </strong>Autologous stem cell transplantation (ASCT) is a standard treatment in transplant-eligible mantle cell lymphoma (MCL) patients after first-line chemoimmunotherapy.</p><p><strong>Study design and methods: </strong>This prospective multicenter study evaluated the impact of CD34<sup>+</sup> cell mobilization and graft cellular composition analyzed by flow cytometry on hematologic recovery and outcome in 42 MCL patients.</p><p><strong>Results: </strong>During CD34<sup>+</sup> cell mobilization, a higher blood CD34<sup>+</sup> cell count (>30 × 10<sup>6</sup>/L) was associated with improved overall survival (median not reached [NR] vs. 57 months, <i>p</i> = 0.04). The use of plerixafor did not impact outcome. Higher number of viable cryopreserved graft CD34<sup>+</sup> cells (>3.0 × 10<sup>6</sup>/kg) was associated with faster platelet (median 11 vs. 15 days, <i>p</i> = 0.03) and neutrophil (median 9 vs. 10 days, <i>p</i> = 0.02) recovery posttransplant. Very low graft CD3<sup>+</sup>CD8<sup>+</sup> cell count (≤10 × 10<sup>6</sup>/kg) correlated with worse progression-free survival (PFS) (HR 4.136, 95% CI 1.547-11.059, <i>p</i> = 0.005). On the other hand, higher absolute lymphocyte count >2.5 × 10<sup>9</sup>/L at 30 days after ASCT (ALC-30) was linked with better PFS (median NR vs. 99 months, <i>p</i> = 0.045) and overall survival (median NR in either group, <i>p</i> = 0.05).</p><p><strong>Conclusions: </strong>Better mobilization capacity and higher graft CD3<sup>+</sup>CD8<sup>+</sup> cell count had a positive prognostic impact in this study, in addition to earlier lymphocyte recovery (ALC-30>2.5 × 10<sup>6</sup>/L). These results need to be validated in another study with a larger patient cohort.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 5","pages":"428-437"},"PeriodicalIF":1.9000,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601603/pdf/","citationCount":"1","resultStr":"{\"title\":\"CD34<sup>+</sup> Cell Mobilization, Autograft Cellular Composition and Outcome in Mantle Cell Lymphoma Patients.\",\"authors\":\"Antti Samuli Turunen, Outi Kuittinen, Hanne Kuitunen, Kaija Vasala, Karri Penttilä, Minna Harmanen, Leena Keskinen, Pentti Mäntymaa, Jukka Pelkonen, Ville Varmavuo, Esa Jantunen, Anu Partanen\",\"doi\":\"10.1159/000531799\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Backgound: </strong>Autologous stem cell transplantation (ASCT) is a standard treatment in transplant-eligible mantle cell lymphoma (MCL) patients after first-line chemoimmunotherapy.</p><p><strong>Study design and methods: </strong>This prospective multicenter study evaluated the impact of CD34<sup>+</sup> cell mobilization and graft cellular composition analyzed by flow cytometry on hematologic recovery and outcome in 42 MCL patients.</p><p><strong>Results: </strong>During CD34<sup>+</sup> cell mobilization, a higher blood CD34<sup>+</sup> cell count (>30 × 10<sup>6</sup>/L) was associated with improved overall survival (median not reached [NR] vs. 57 months, <i>p</i> = 0.04). The use of plerixafor did not impact outcome. Higher number of viable cryopreserved graft CD34<sup>+</sup> cells (>3.0 × 10<sup>6</sup>/kg) was associated with faster platelet (median 11 vs. 15 days, <i>p</i> = 0.03) and neutrophil (median 9 vs. 10 days, <i>p</i> = 0.02) recovery posttransplant. Very low graft CD3<sup>+</sup>CD8<sup>+</sup> cell count (≤10 × 10<sup>6</sup>/kg) correlated with worse progression-free survival (PFS) (HR 4.136, 95% CI 1.547-11.059, <i>p</i> = 0.005). On the other hand, higher absolute lymphocyte count >2.5 × 10<sup>9</sup>/L at 30 days after ASCT (ALC-30) was linked with better PFS (median NR vs. 99 months, <i>p</i> = 0.045) and overall survival (median NR in either group, <i>p</i> = 0.05).</p><p><strong>Conclusions: </strong>Better mobilization capacity and higher graft CD3<sup>+</sup>CD8<sup>+</sup> cell count had a positive prognostic impact in this study, in addition to earlier lymphocyte recovery (ALC-30>2.5 × 10<sup>6</sup>/L). These results need to be validated in another study with a larger patient cohort.</p>\",\"PeriodicalId\":23252,\"journal\":{\"name\":\"Transfusion Medicine and Hemotherapy\",\"volume\":\"50 5\",\"pages\":\"428-437\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-08-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601603/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transfusion Medicine and Hemotherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000531799\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/10/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transfusion Medicine and Hemotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000531799","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
CD34+ Cell Mobilization, Autograft Cellular Composition and Outcome in Mantle Cell Lymphoma Patients.
Backgound: Autologous stem cell transplantation (ASCT) is a standard treatment in transplant-eligible mantle cell lymphoma (MCL) patients after first-line chemoimmunotherapy.
Study design and methods: This prospective multicenter study evaluated the impact of CD34+ cell mobilization and graft cellular composition analyzed by flow cytometry on hematologic recovery and outcome in 42 MCL patients.
Results: During CD34+ cell mobilization, a higher blood CD34+ cell count (>30 × 106/L) was associated with improved overall survival (median not reached [NR] vs. 57 months, p = 0.04). The use of plerixafor did not impact outcome. Higher number of viable cryopreserved graft CD34+ cells (>3.0 × 106/kg) was associated with faster platelet (median 11 vs. 15 days, p = 0.03) and neutrophil (median 9 vs. 10 days, p = 0.02) recovery posttransplant. Very low graft CD3+CD8+ cell count (≤10 × 106/kg) correlated with worse progression-free survival (PFS) (HR 4.136, 95% CI 1.547-11.059, p = 0.005). On the other hand, higher absolute lymphocyte count >2.5 × 109/L at 30 days after ASCT (ALC-30) was linked with better PFS (median NR vs. 99 months, p = 0.045) and overall survival (median NR in either group, p = 0.05).
Conclusions: Better mobilization capacity and higher graft CD3+CD8+ cell count had a positive prognostic impact in this study, in addition to earlier lymphocyte recovery (ALC-30>2.5 × 106/L). These results need to be validated in another study with a larger patient cohort.
期刊介绍：
This journal is devoted to all areas of transfusion medicine. These include the quality and security of blood products, therapy with blood components and plasma derivatives, transfusion-related questions in transplantation, stem cell manipulation, therapeutic and diagnostic problems of homeostasis, immuno-hematological investigations, and legal aspects of the production of blood products as well as hemotherapy. Both comprehensive reviews and primary publications that detail the newest work in transfusion medicine and hemotherapy promote the international exchange of knowledge within these disciplines. Consistent with this goal, continuing clinical education is also specifically addressed.
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