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Clinical Trial
. 2021 Jun;61(6):1830-1844.
doi: 10.1111/trf.16424. Epub 2021 May 6.

Autograft cellular composition and outcome in myeloma patients: Results of the prospective multicenter GOA study

Antti Turunen  1   2 , Raija Silvennoinen  1   3 , Anu Partanen  1 , Jaakko Valtola  1 , Timo Siitonen  4 , Mervi Putkonen  5 , Marja Sankelo  6 , Marja Pyörälä  1 , Taru Kuittinen  1 , Karri Penttilä  7   8 , Anu Sikiö  9 , Eeva-Riitta Savolainen  10 , Pentti Mäntymaa  11 , Jukka Pelkonen  11   12 , Ville Varmavuo  13 , Esa Jantunen  1   2   14
Affiliations
Free article
Clinical Trial

Autograft cellular composition and outcome in myeloma patients: Results of the prospective multicenter GOA study

Antti Turunen et al. Transfusion. 2021 Jun.
Free article

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 × 106 /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 × 106 /kg, p = 0.009) and NK cell count (>2.5 × 106 /kg, p = 0.026), lenalidomide maintenance and standard-risk cytogenetics predicted better PFS. In contrast, a higher CD34+ count (>2.5 × 106 /kg, p = 0.015) predicted worse PFS. A very low CD3+ cell count (≤20 × 106 /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.

Keywords: CD34+ cells; NK cells; T lymphocytes; autograft cellular composition; autologous stem cell transplantation; hematologic recovery; myeloma; outcome.

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References

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