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

doi:10.14740/jh939

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

J Hematol. 2021 Dec;10(6):246-254. doi: 10.14740/jh939. Epub 2021 Dec 13.

Authors

Anu Partanen¹, Outi Kuittinen^{2

3

4}, Antti Turunen¹, Jaakko Valtola¹, Marja Pyorala¹, Hanne Kuitunen⁴, Kaija Vasala⁵, Taru Kuittinen¹, Pentti Mantymaa⁶, Jukka Pelkonen^{6

7}, Esa Jantunen^{1

2

8}, Ville Varmavuo⁹

Affiliations

¹ Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
² Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
³ Department of Oncology, Kuopio University Hospital, Kuopio, Finland.
⁴ Department of Oncology, Oulu University Hospital, Oulu, Finland.
⁵ Department of Oncology, Central Hospital of Central Finland, Jyvaskyla, Finland.
⁶ Eastern Finland Laboratory Centre, Kuopio, Finland.
⁷ Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland.
⁸ Department of Medicine, North Karelia Hospital District, Joensuu, Finland.
⁹ Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland.

PMID: 35059086
PMCID: PMC8734492
DOI: 10.14740/jh939

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.

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