Blood Graft and Outcome After Autologous Stem Cell Transplantation in Patients With Primary Central Nervous System Lymphoma

Anu Partanen, Outi Kuittinen, Antti Turunen, Jaakko Valtola, Marja Pyorala, Hanne Kuitunen, Kaija Vasala, Taru Kuittinen, Pentti Mantymaa, Jukka Pelkonen, Esa Jantunen, Ville Varmavuo

Abstract


Background: Autologous stem cell transplantation (auto-SCT) is a treatment option for patients with primary central nervous system lymphoma (PCNSL).

Methods: In this prospective multicenter study, the effects of blood graft cellular content on hematologic recovery and outcome were analyzed in 17 PCNSL patients receiving auto-SCT upfront.

Results: The infused viable CD34+ cell count > 1.7 106/kg correlated with more rapid platelet engraftment (10 vs. 31 days, P = 0.027) and with early neutrophil recovery (day + 15) (5.4 vs. 1.6 109/L, P = 0.047). A higher number of total collected CD34+ cells > 3.3 106/kg infused predicted worse 5-year progression-free survival (PFS) (33% vs. 100%, P = 0.028). In addition, CD3+CD8+ T cells > 78 106/kg in the infused graft impacted negatively on the 5-year PFS (0% vs. 88%, P = 0.016).

Conclusion: The cellular composition of infused graft seems to impact on the hematologic recovery and PFS post-transplant. Further studies are needed to verify the optimal autograft cellular content in PCNSL.




J Hematol. 2021;10(6):246-254
doi: https://doi.org/10.14740/jh939

Keywords


CD34+ cell mobilization; Primary central nervous lymphoma; Autologous stem cell transplantation; Autograft cellular composition; Outcome

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