CD34+ selected versus unselected autologous stem cell transplantation in patients with advanced-stage mantle cell and diffuse large B-cell lymphoma

Martin D Berger; Giacomo Branger; Kurt Leibundgut; Gabriela M Baerlocher; Katja Seipel; Beatrice U Mueller; Michael Gregor; Axel Ruefer; Thomas Pabst

doi:10.1016/j.leukres.2015.03.004

CD34+ selected versus unselected autologous stem cell transplantation in patients with advanced-stage mantle cell and diffuse large B-cell lymphoma

Leuk Res. 2015 Jun;39(6):561-7. doi: 10.1016/j.leukres.2015.03.004. Epub 2015 Mar 19.

Authors

Martin D Berger¹, Giacomo Branger¹, Kurt Leibundgut², Gabriela M Baerlocher³, Katja Seipel⁴, Beatrice U Mueller⁴, Michael Gregor⁵, Axel Ruefer⁵, Thomas Pabst⁶

Affiliations

¹ Department of Medical Oncology, University Hospital and University of Berne, Berne, Switzerland.
² Department of Pediatrics, University Hospital and University of Berne, Berne, Switzerland.
³ Department of Hematology, University Hospital and University of Berne, Berne, Switzerland.
⁴ Department of Clinical Research, University Hospital and University of Berne, Berne, Switzerland.
⁵ Department of Hematology, Kantonsspital, Lucerne, Switzerland.
⁶ Department of Medical Oncology, University Hospital and University of Berne, Berne, Switzerland; Department of Clinical Research, University Hospital and University of Berne, Berne, Switzerland. Electronic address: thomas.pabst@insel.ch.

PMID: 25890431
DOI: 10.1016/j.leukres.2015.03.004

Abstract

Novel strategies aiming to increase survival rates in patients with advanced-stage mantle cell lymphoma (MCL) and relapsing diffuse large B-cell lymphoma (DLBCL) are a clinical need. High-dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) has improved progression-free (PFS) and overall survival (OS) in MCL and relapsed DLBCL. However, the role of CD34+ cell selection before ASCT in MCL and DLBCL is unclear. We retrospectively analyzed the outcome of 62 consecutive patients with advanced-stage MCL or relapsed DLBCL undergoing ASCT with (n=31) or without (n=31) prior CD34+ selection. All patients had stage III or IV disease, with 47% having DLBCL and 53% MCL. The median duration for neutrophil and platelet recovery was 12 and 16 days in CD34+ selected patients, and 11 (P<.001) and 14 days (P=.012) in the group without selection, respectively. No differences in toxicities were observed. The 5-year PFS for CD34+ selected versus not selected patients was 67% and 39% (P=.016), and the 5-year OS was 86% and 54% (P=.007). Our data suggest that using CD34+ selected autografts for ASCT in advanced stage MCL and DLBCL is associated with longer PFS and OS without increased toxicity.

Keywords: Autologous transplantation; CD34 selection; Diffuse large B-cell lymphoma; Mantle cell lymphoma; Outcome; Purging; Stem cell; Survival.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Antigens, CD34*
Autografts
Disease-Free Survival
Humans
Lymphoma, Large B-Cell, Diffuse / mortality*
Lymphoma, Large B-Cell, Diffuse / therapy*
Lymphoma, Mantle-Cell / mortality*
Lymphoma, Mantle-Cell / therapy*
Male
Middle Aged
Stem Cell Transplantation / methods*
Survival Rate

Substances

Antigens, CD34