A1 Refereed original research article in a scientific journal
Autograft cellular composition and outcome in myeloma patients: Results of the prospective multicenter GOA study
Authors: Turunen Antti, Silvennoinen Raija, Partanen Anu, Valtola Jaakko, Siitonen Timo, Putkonen Mervi, Sankelo Marja, Pyorälä Marja, Kuittinen Taru, Penttilä Karri, Sikiö Anu, Savolainen Eeva-Riitta, Mäntymaa Pentti, Pelkonen Jukka, Varmavuo Ville, Jantunen Esa
Publisher: WILEY
Publication year: 2021
Journal: Transfusion
Journal acronym: TRANSFUSION
Volume: 61
Issue: 6
First page : 1830
Last page: 1844
Number of pages: 15
ISSN: 0041-1132
eISSN: 0041-1132
DOI: https://doi.org/10.1111/trf.16424
Web address : https://onlinelibrary.wiley.com/doi/10.1111/trf.16424
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/59923755
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 x 10/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 x 10/kg, p = 0.009) and NK cell count (>2.5 x 10/kg, p = 0.026), lenalidomide maintenance and standard-risk cytogenetics predicted better PFS. In contrast, a higher CD34(+) count (>2.5 x 10/kg, p = 0.015) predicted worse PFS. A very low CD3(+) cell count (<= 20 x 10/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.
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