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Yamaguchi J, Chinen Y, Takimoto-Shimomura T, Nagata H, Muramatsu A, Kuriyama K, Ohshiro M, Hirakawa Y, Iwai T, Uchiyama H, Uoshima N, Kaneko H, Nakao M, Tsukamoto T, Shimura Y, Kobayashi T, Horiike S, Yokota I, Kuroda J. Prediction of delayed platelet engraftment after autologous stem cell transplantation for B-cell non-Hodgkin lymphoma. Leuk Lymphoma 2019; 60:3434-3441. [PMID: 31318305 DOI: 10.1080/10428194.2019.1636982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Delayed platelet engraftment (DPE) is occasionally observed despite prompt neutrophil engraftment after autologous peripheral blood stem cell transplantation (auto-PBSCT). To identify risk factors for DPE and to develop a simple and clinically applicable system for predicting the time required for platelet recovery, we conducted a multi-institutional retrospective study in 144 patients with B-cell non-Hodgkin lymphoma who underwent auto-PBSCT. In a median observation period of 930 days (range: 25-5272 days), 139 patients successfully achieved platelet engraftment (≥50.0 × 109/L). The median duration for platelet engraftment was 19 days, and 130 patients had platelet engraftment within 40 days after auto-PBSCT; however, the other 14 patients failed to achieve platelet engraftment within 60 days. These 14 patients with DPE required a significantly greater number of apheresis procedures and had a lower pre-apheresis absolute lymphocyte count (PA-ALC) compared to those without DPE. Importantly, multivariate analysis revealed that the number of transplanted CD34+ cells (≤2.0 × 106/kg), number of required apheresis procedures (≥3 days), and PA-ALC (≤1.0 × 109/L) were independently associated with a longer time for platelet engraftment after auto-PBSCT. By incorporating these three independent factors as variables, we generated a new scoring system for prediction of the time and probability for platelet engraftment after auto-PBSCT.
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Affiliation(s)
- Junko Yamaguchi
- Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiaki Chinen
- Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomoko Takimoto-Shimomura
- Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroaki Nagata
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Ayako Muramatsu
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Kodai Kuriyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Muneo Ohshiro
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yoshiko Hirakawa
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Toshiki Iwai
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hitoji Uchiyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Hiroto Kaneko
- Department of Hematology, Aiseikai Yamashina Hospital, Kyoto, Japan
| | - Mitsushige Nakao
- Department of Internal Medicine, Otsu Municipal Hospital, Otsu, Japan
| | - Taku Tsukamoto
- Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Shimura
- Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tsutomu Kobayashi
- Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeo Horiike
- Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Isao Yokota
- Department of Biostatistics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junya Kuroda
- Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Ma X, Wong SW, Zhou P, Chaulagain CP, Doshi P, Klein AK, Sprague K, Kugelmass A, Toskic D, Warner M, Miller KB, Lee L, Varga C, Comenzo RL. Daratumumab binds to mobilized CD34+ cells of myeloma patients in vitro without cytotoxicity or impaired progenitor cell growth. Exp Hematol Oncol 2018; 7:27. [PMID: 30356940 PMCID: PMC6192105 DOI: 10.1186/s40164-018-0119-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 10/06/2018] [Indexed: 02/08/2023] Open
Abstract
Background The monoclonal antibody daratumumab, approved for treating myeloma, targets CD38, a protein on myeloma and also on CD34+ hematopoietic progenitor cells. Because mobilized CD34+ cells are critical for stem cell transplant, we investigated the in vitro activity of daratumumab on mobilized CD34+ cells from myeloma patients with no prior exposure to daratumumab. Methods We determined the number of CD38 molecules per CD34+ cell, and whether daratumumab bound to CD34+ cells, whether C1q bound to daratumumab-coated CD34+ cells and whether daratumumab-related complement-dependent cytotoxicity (CDC) occurred. We also examined CD34+ cell progenitor cell colony capacity in assays with pre-plating incubation of CD34+ cells with daratumumab alone or with daratumumab and the CD59 inhibitory antibody BRIC229, and also assessed CD34+ cell responses to increasing doses of daratumumab in caspase 3/7 activity assays. Results Although 75% of mobilized CD34+ cells co-express CD38, CD38 was minimally present on CD34+ cells compared to Daudi and KG-1 controls, C1q did not bind to daratumumab-coated CD34+ cells, and CDC did not occur. CD34+ cells incubated in complement-rich human serum with daratumumab alone or with daratumumab and BRIC229, and then plated in progenitor cell assays, produced similar numbers of colonies as controls. In progenitor cell assays with cryopreserved or fresh unselected or CD34-selected cells, daratumumab did not affect progenitor cell capacity, and in caspase 3/7 activity assays CD34+ cells were not affected by increasing doses of daratumumab. Conclusion In vitro, daratumumab is not toxic to mobilized CD34+ progenitor cells from myeloma patients.
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Affiliation(s)
- Xun Ma
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Sandy W Wong
- 2Division of Hematology and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, CA USA
| | - Ping Zhou
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Chakra P Chaulagain
- Taussig Cancer Institute of Cleveland Clinic, Maroone Cancer Center, Weston, FL USA
| | - Parul Doshi
- 4Janssen Research & Development, Spring House, PA USA
| | - Andreas K Klein
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Kellie Sprague
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Adin Kugelmass
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Denis Toskic
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Melissa Warner
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Kenneth B Miller
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Lisa Lee
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Cindy Varga
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
| | - Raymond L Comenzo
- 1The John C Davis Myeloma and Amyloid Program in the Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, 800 Washington Street, Box 826, Boston, MA 02111 USA
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