1.
Efficacy of ex vivo purging with CD34+ selection to maximize the effects of autologous stem cell transplantation in peripheral T-cell lymphoma patients
Jeon, Y., Kim, T. Y., Min, G. J., Park, S. S., Park, S., Yoon, J. H., Lee, S. E., Cho, B. S., Eom, K. S., Kim, Y. J., et al
Cytotherapy. 2023
Abstract
BACKGROUND AIMS Peripheral T-cell lymphomas (PTCLs) are rare and aggressive tumors with uncertain optimal treatment. This study investigated the clinical outcomes of high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) after CD34+ selective purging in PTCL patients. METHODS Retrospective analysis included 67 PTCL patients who achieved remission and underwent HDT/ASCT. CD34+ selective purging was performed using CliniMACS® (Miltenyi Biotec, Bergisch Gladbach, Germany). Survival outcomes, engraftment, lymphocyte subsets and viral infections were evaluated. RESULTS CD34+ selective purged autografts were associated with significantly improved overall survival (OS) and disease-free survival (DFS) compared with unpurged autografts (5-year OS, 73.3% versus 37.8%, 5-year DFS, 73.8% versus 33.4%). The cumulative incidence of relapse was also lower in the purged group (31.5% versus 73.3%). Subgroup analysis revealed significant survival benefits in the high-risk group receiving purged autografts. Lymphocyte subset analysis showed increased natural killer (NK) cell counts in the purged group after ASCT. Higher post-ASCT lymphocyte-to-monocyte ratio (LMR) was associated with improved OS and DFS. CONCLUSIONS CD34+ selective purging in PTCL patients undergoing HDT/ASCT improved survival outcomes and reduced relapse risk. The procedure increased NK cell counts and post-ASCT LMR. CD34+ selective purging may minimize autograft tumor cell contamination and enhance efficacy in T-cell lymphomas.
2.
Loss of CD34(+) Cells and Effect of the Number of Viable Cryopreserved CD34(+) Cells in the Infused Blood Grafts on Hematologic Recovery, Progression-Free Survival and Overall Survival in NHL Patients After Autologous Stem Cell Transplantation
Partanen, A., Turunen, A., Valtola, J., Pyörälä, M., Kuittinen, O., Kuitunen, H., Vasala, K., Penttilä, K., Kuittinen, T., Mäntymaa, P., et al
Clinical lymphoma, myeloma & leukemia. 2023
Abstract
PATIENTS This post-hoc study aimed to find out factors affecting graft viable CD34(+) cell loss during processing and cryopreservation in 129 non-Hodgkin lymphoma (NHL) patients receiving autologous stem cell transplantation (auto-SCT) and the impact of a low (< 2.0 × 10(6)/kg, group A) and a decent number (≥ 2 × 10(6)/kg, group B) of viable CD34(+) cells infused on the hematologic recovery, progression-free survival (PFS) and overall survival (OS) after auto-SCT. RESULTS The median loss of viable CD34(+) cells during cryopreservation was higher in group A (47% vs. 19%, p < .001). A higher yield of CD34(+) cells at the first apheresis in group B (p = .002) was linked with greater loss of viable graft CD34(+) cells after cryopreservation. Filgrastim (FIL) use for mobilization seemed to associate with higher viable CD34(+) cell loss compared to pegfilgrastim (PEG) or lipegfilgrastim (LIPEG) in both groups (in group A FIL 66 vs. PEG 35%, p = .006; in group B FIL 37 vs. PEG 15 vs. LIPEG 13%, p < .001). Hematologic recovery after auto-SCT was faster in group B. Neither viable CD34(+) cell loss during storage nor viable CD34(+) cell number < 2.0 × 10(6)/kg infused affected on PFS or OS. CONCLUSIONS G-CSF type used in mobilization and mobilization capacity were found to correlate with viable CD34(+) cell loss during processing and storage. Most importantly, low infused viable CD34(+) cell count did not seem to impact on PFS or OS.