Mobilization characteristics, blood graft composition, and outcome in diffuse large B‐cell lymphoma after autologous stem cell transplantation: Results from the prospective multicenter GOA study

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2021-02, Vol.61 (2), p.516-525
• Main Authors: Partanen, Anu, Turunen, Antti, Valtola, Jaakko, Pyörälä, Marja, Vasala, Kaija, Kuittinen, Outi, Kuitunen, Hanne, Penttilä, Karri, Keskinen, Leena, Kuittinen, Taru, Mäntymaa, Pentti, Pelkonen, Jukka, Varmavuo, Ville, Jantunen, Esa
• Format: Article
• Language: English
• Subjects: Apheresis; autograft cellular composition; Autografts; B-cell lymphoma; Blood; CD3 antigen; CD34 antigen; CD34+ cell mobilization; CD38 antigen; Composition; diffuse large B‐cell lymphoma; Grafting; hematologic recovery; Leukocytes (neutrophilic); Lymphoma; Multivariate analysis; outcome; Recovery; Stem cell transplantation; Stem cells; Survival; Transplantation
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/trf.16198

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.