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Turunen AS, Kuittinen O, Kuitunen H, Vasala K, Penttilä K, Harmanen M, Keskinen L, Mäntymaa P, Pelkonen J, Varmavuo V, Jantunen E, Partanen A. CD34 + Cell Mobilization, Autograft Cellular Composition and Outcome in Mantle Cell Lymphoma Patients. Transfus Med Hemother 2023; 50:428-437. [PMID: 37899989 PMCID: PMC10601603 DOI: 10.1159/000531799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/21/2023] [Indexed: 10/31/2023] Open
Abstract
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.
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Affiliation(s)
| | - Outi Kuittinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Oncology, Kuopio University Hospital, Kuopio, Finland
- Cancer Centre, Oulu University Hospital, Oulu, Finland
| | | | - Kaija Vasala
- Department of Oncology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Karri Penttilä
- Department of Medicine, Savonlinna Central Hospital, Savonlinna, Finland
- Finnish Medicines Agency, Kuopio, Finland
| | - Minna Harmanen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Leena Keskinen
- Department of Oncology, Tampere University Hospital, Tampere, Finland
| | | | - Jukka Pelkonen
- Laboratory Centre of Eastern Finland, Kuopio, Finland
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, North Carelia Hospital District, Joensuu, Finland
| | - Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
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Maegawa S, Chinen Y, Shimura Y, Tanba K, Takimoto T, Mizuno Y, Matsumura-Kimoto Y, Kuwahara-Ota S, Tsukamoto T, Kobayashi T, Horiike S, Taniwaki M, Kuroda J. Phosphoinositide-dependent protein kinase 1 is a potential novel therapeutic target in mantle cell lymphoma. Exp Hematol 2018; 59:72-81.e2. [DOI: 10.1016/j.exphem.2017.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/15/2017] [Accepted: 12/17/2017] [Indexed: 10/18/2022]
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