Autograft cellular composition and outcome in myeloma patients: Results of the prospective multicenter GOA study. Issue 6 (6th May 2021)

• Record Type: Journal Article
• Authors: Turunen, Antti; Silvennoinen, Raija; Partanen, Anu; Valtola, Jaakko; Siitonen, Timo; Putkonen, Mervi; Sankelo, Marja; Pyörälä, Marja; Kuittinen, Taru; Penttilä, Karri; Sikiö, Anu; Savolainen, Eeva‐Riitta; Mäntymaa, Pentti; Pelkonen, Jukka; Varmavuo, Ville; Jantunen, Esa
• Is Part Of: Transfusion. Volume 61:Issue 6(2021)
• Page Start: 1830
• Page End: 1844
• Publication Date: 2021-05-06
• Subjects: autograft cellular composition -- autologous stem cell transplantation -- CD34+ cells -- hematologic recovery -- myeloma -- NK cells -- outcome -- T lymphocytes; Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.16424
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract: Background: Autologous stem cell transplantation (auto‐SCT) is a widely used treatment option in multiple myeloma (MM) patients. The optimal graft cellular composition is not known. Study design and methods: Autograft cellular composition was analyzed after freezing by flow cytometry in 127 MM patients participating in a prospective multicenter study. The impact of graft cellular composition on hematologic recovery and outcome after auto‐SCT was evaluated. Results: A higher graft CD34 + cell content predicted faster platelet recovery after auto‐SCT in both the short and long term. In patients with standard‐risk cytogenetics, a higher graft CD34 + count (>2.5 × 10 6 /kg) was linked with shorter progression‐free survival (PFS; 28 vs. 46 months, p = 0.04), but there was no difference in overall survival (OS) ( p = 0.53). In a multivariate model, a higher graft CD34 + CD133 + CD38 − (>0.065 × 10 6 /kg, p = 0.009) and NK cell count (>2.5 × 10 6 /kg, p = 0.026), lenalidomide maintenance and standard‐risk cytogenetics predicted better PFS. In contrast, a higher CD34 + count (>2.5 × 10 6 /kg, p = 0.015) predicted worse PFS. A very low CD3 + cell count (≤20 × 10 6 /kg, p = 0.001) in the infused graft and high‐risk cytogenetics remained predictive of worse OS. Conclusions: Autograft cellular composition may impact outcome in MM patients after auto‐SCT. More studies are needed to define optimal graft composition.