Partanen Anu, Turunen Antti, Kuittinen Outi, Kuitunen Hanne, Mäntymaa Pentti, Varmavuo Ville, Jantunen Esa
Department of Medicine, Kuopio University Hospital, 70290 Kuopio, Finland.
Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland.
Cancers (Basel). 2024 Jul 16;16(14):2550. doi: 10.3390/cancers16142550.
Early lymphocyte recovery as manifested by an absolute lymphocyte count at d+15 (ALC-15) ≥ 0.5 × 10/L after autologous hematopoietic stem cell transplantation (AHCT) has been associated with a better outcome. This prospective multicenter study aimed to clarify factors associated with ALC-15 ≥ 0.5 × 10/L after AHCT among 178 patients with non-Hodgkin lymphoma. The mobilization capacity, as manifested by peak blood CD34 cell numbers > 45 × 10/L correlated with higher ALC-15 levels ( = 0.020). In addition, the amount of CD3CD4 T cells > 31.8 × 10/kg in the infused graft predicted ALC-15 ≥ 0.5 × 10/L ( < 0.001). Also, the number of infused graft CD3CD8 T cells > 28.8 × 10/kg ( = 0.017) and NK cells > 4.4 × 10/kg was linked with higher ALC-15 ( < 0.001). The two-year progression-free survival after AHCT was significantly better in patients with ALC-15 ≥ 0.5 × 10/L (74 vs. 57%, = 0.027). The five-year OS in patients with higher ALC-15 was 78% vs. 60% in those with lower ALC-15 ( = 0.136). To conclude, the mobilization capacity of CD34 cells and detailed measures of graft cellular content mark prognostic tools that predict ALC-15 ≥ 0.5 × 10/L, which is associated with a better outcome in NHL patients after AHCT.
自体造血干细胞移植(AHCT)后第15天的绝对淋巴细胞计数(ALC-15)≥0.5×10⁹/L所体现的早期淋巴细胞恢复与较好的预后相关。这项前瞻性多中心研究旨在阐明178例非霍奇金淋巴瘤患者AHCT后ALC-15≥0.5×10⁹/L的相关因素。动员能力,以峰值血CD34细胞数>45×10⁶/L体现,与较高的ALC-15水平相关(P = 0.020)。此外,输注移植物中CD3⁺CD4⁺T细胞数量>31.8×10⁶/kg可预测ALC-15≥0.5×10⁹/L(P<0.001)。同样,输注移植物中CD3⁺CD8⁺T细胞数量>28.8×10⁶/kg(P = 0.017)和NK细胞数量>4.4×10⁶/kg与较高的ALC-15相关(P<0.001)。AHCT后,ALC-15≥0.5×10⁹/L的患者两年无进展生存率显著更高(74%对57%,P = 0.027)。ALC-15较高的患者五年总生存率为78%,而ALC-15较低的患者为60%(P = 0.136)。总之,CD34细胞的动员能力和移植物细胞含量的详细指标是预测ALC-15≥0.5×10⁹/L的预后工具,这与NHL患者AHCT后的较好预后相关。