套细胞淋巴瘤患者的CD34细胞动员、自体移植细胞组成及预后

CD34 Cell Mobilization, Autograft Cellular Composition and Outcome in Mantle Cell Lymphoma Patients.

作者信息

Turunen Antti Samuli, Kuittinen Outi, Kuitunen Hanne, Vasala Kaija, Penttilä Karri, Harmanen Minna, Keskinen Leena, Mäntymaa Pentti, Pelkonen Jukka, Varmavuo Ville, Jantunen Esa, Partanen Anu

机构信息

Department of Medicine, Kuopio University Hospital, Kuopio, Finland.

Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.

出版信息

Transfus Med Hemother. 2023 Aug 23;50(5):428-437. doi: 10.1159/000531799. eCollection 2023 Oct.

DOI:10.1159/000531799

PMID:37899989

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10601603/

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 × 10/L) was associated with improved overall survival (median not reached [NR] vs. 57 months, = 0.04). The use of plerixafor did not impact outcome. Higher number of viable cryopreserved graft CD34 cells (>3.0 × 10/kg) was associated with faster platelet (median 11 vs. 15 days, = 0.03) and neutrophil (median 9 vs. 10 days, = 0.02) recovery posttransplant. Very low graft CD3CD8 cell count (≤10 × 10/kg) correlated with worse progression-free survival (PFS) (HR 4.136, 95% CI 1.547-11.059, = 0.005). On the other hand, higher absolute lymphocyte count >2.5 × 10/L at 30 days after ASCT (ALC-30) was linked with better PFS (median NR vs. 99 months, = 0.045) and overall survival (median NR in either group, = 0.05).

CONCLUSIONS

Better mobilization capacity and higher graft CD3CD8 cell count had a positive prognostic impact in this study, in addition to earlier lymphocyte recovery (ALC-30>2.5 × 10/L). These results need to be validated in another study with a larger patient cohort.

摘要

背景

自体干细胞移植（ASCT）是符合移植条件的套细胞淋巴瘤（MCL）患者一线化疗免疫治疗后的标准治疗方法。

研究设计与方法

这项前瞻性多中心研究评估了42例MCL患者中通过流式细胞术分析的CD34细胞动员和移植物细胞组成对血液学恢复和预后的影响。

结果

在CD34细胞动员期间，较高的血液CD34细胞计数（>30×10/L）与总生存期改善相关（中位生存期未达到[NR] vs. 57个月，P = 0.04）。普乐沙福的使用对预后无影响。较高数量的可存活冻存移植物CD34细胞（>3.0×10/kg）与移植后更快的血小板（中位时间11天vs. 15天，P = 0.03）和中性粒细胞（中位时间9天vs. 10天，P = 0.02）恢复相关。极低的移植物CD3CD8细胞计数（≤10×10/kg）与无进展生存期（PFS）较差相关（风险比4.136，95%置信区间1.547 - 11.059，P = 图005）。另一方面，ASCT后30天较高的绝对淋巴细胞计数>2.5×10/L（ALC - 30）与更好的PFS（中位生存期NR vs. 99个月，P = 0.045）和总生存期（两组中位生存期均为NR，P = 0.05）相关。