Peripheral blood stem cell CD34+ autologous transplant in relapsed follicular lymphoma

• Published in: Hematology and cell therapy 1997-02, Vol.39 (1), p.33-40
• Main Authors: MARIN, G. H, DAL CORTIVO, L, CAYUELA, J. M, MAROLLEAU, J. P, PAUTIER, P, COJEAN-ZELEK, I, BRICE, P, MAKKE, J, BENBUNAN, M, GISSELBRECHT, C
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antigens, CD34; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Graft Survival; Hematopoietic Stem Cell Transplantation; Humans; Lymphoma, Follicular - pathology; Lymphoma, Follicular - therapy; Medical sciences; Middle Aged; Recurrence; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Autologous; Treatment Outcome
• ISSN: 1269-3286; 1279-8509
• DOI: 10.1007/s00282-997-0033-4

To evaluate CD34+ selection of peripheral blood stem cells (PBSC) as a graft for autologous transplantation. Eight relapsing follicular lymphoma (FL) patients were submitted to CD34+ autologous stem cell transplantation (ASCT). All patients received at least two front line conventional therapies; mean time to treatment failure (TTF) was 4.5 months. Patients had disseminated stage III-IV disease after a median number of 2.1 relapses. Chemotherapy and G-CSF were used as mobilization for leukapheresis. CEPRATE SC concentrator (CellPro, Inc, Bothell, WA) was used to select CD34+ cells from leukapheresis products. With a mean of 1.8 leukaphereses per patient, 8.1 x 10(8) mononuclear cells (MNCs)/kg were collected. After the selection process, the median number of MNCs was 9.4 x 10(6)/kg; 4.3 x 10(6)/kg CD34+ cells and 17 x 10(4)/kg CFU-GM, with a purity of 83.7% and a viability of 89.2%. Mbr bcl2/IgH PCR analysis of 5 grafts showed that initial buffy-coat, and CD34- fractions were negative in 3 cases and positive in 2 cases (from whom selected CD34+ fraction remained positive in 1 case). After a conditioning regimen including total body irradiation, cyclophosphamide and etoposide, CD34+ selected cells were reinfused. All patients but one had successful engraftment, median time to WBC > 1 x 10(9)/l was 12 days and platelets > 50 x 10(9)/l 17 days. No severe infectious complications were seen. After transplant, with a minimum follow up of 2 years, 5 patients are still in complete remission (CR). Three patients have relapsed after 1 year of transplant with a mean TTF of 15.6 months. We conclude that PBSC CD34+ selection for ASCT was a safe technique, capable of reconstituting hemopoiesis without severe complications for high risk FL patients included in this study. The effects of tumor cell purging need to be evaluated in a larger series.