Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants
Background/Aim. Autologous stem cell transplants (ASCTs) improve the rate of overall survival (OS) in patients with hematological malignancies such as multiple myeloma (MM) after induction chemotherapy, aggressive non-Hodgkin's lymphomas (NHL), and relapsed, chemotherapy- sensitive Hodgkin'...
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| Format: | Article |
| Language: | English |
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Military Health Department, Ministry of Defance, Serbia
2020-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800160T.pdf |
| _version_ | 1819143962489782272 |
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| author | Todorović-Balint Milena Bila Jelena Balint Bela Jeličić Jelena Đunić Irena Antić Darko Kraguljac-Kurtović Nada Vujić Dragana Mihaljević Biljana |
| author_facet | Todorović-Balint Milena Bila Jelena Balint Bela Jeličić Jelena Đunić Irena Antić Darko Kraguljac-Kurtović Nada Vujić Dragana Mihaljević Biljana |
| author_sort | Todorović-Balint Milena |
| collection | DOAJ |
| description | Background/Aim. Autologous stem cell transplants (ASCTs) improve the rate of overall survival (OS) in patients with hematological malignancies such as multiple myeloma (MM) after induction chemotherapy, aggressive non-Hodgkin's lymphomas (NHL), and relapsed, chemotherapy- sensitive Hodgkin's lymphoma (HL). The study aim was to evaluate influence of applied CD34+ cell quantity on clinical outcome, as well as early post-transplant and overall survival (OS) of HL and MM patients following ASCT. Methods. This study included a total of 210 patients (90 HL/120 MM) who underwent ASCT. Stem cell (SC) mobilization was accomplished by granulocyte-colony stimulating factor (G-CSF) 10–16 μg/kg body mass (bm) following chemotherapy. For proven poor mobilizers, mobilization with G-CSF (16 μg/kgbm) and Plerixafor (24 or 48 mg) was performed. To our best knowledge, it was the first usage of the Plerixafor in our country in the ASCT-setting. Harvesting was initiated merely at "cut-off-value" of CD34+ cells ≥ 20 × 106/L in peripheral blood with "target-dose" of CD34+ cells ≥ 5 × 106/kgbm in harvest. The CD34+ cell count and viability was determined using flow cytometry. Results. The majority of HL patients (76.7%) were infused with > 5.0 × 106/kgbm CD34+ cells, while 68.3% of MM patients were treated by approximately 4.0–5.4 × 106/kgbm CD34+ dose, respectively. Beneficial response (complete/ partial remission) was achieved in 83.3% (HL) and 94.2% (MM) patients. Among parameters that influenced survival of HL patients with positive response to the therapy, multivariate analysis (pre-ASCT performance status, CD34+ cell quantity applied, rapid hematopoietic, i.e. lymphocyte and platelet recovery) indicated that higher CD34+ cell dose used, along with pre-ASCT performance status correlated with superior event-free survival (EFS) and OS following ASCT. In MM patients, multivariate analysis (renal impairment, infused CD34+ cell quantity, early platelet recovery) indicated that the number of CD34+ cells infused was the most important parameter that influenced both EFS and OS after ASCT. Conclusion. Data obtained in this study undoubtedly confirmed that CD34+ cell dose applied is an independent factor that may contribute to superior clinical outcome and OS of HL and MM patients following ASCT. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 41004 and Grant no. III 41030] |
| first_indexed | 2024-12-22T12:34:34Z |
| format | Article |
| id | doaj.art-57f56c6671cf4c9dbb3ce67f32f68606 |
| institution | Directory Open Access Journal |
| issn | 0042-8450 2406-0720 |
| language | English |
| last_indexed | 2024-12-22T12:34:34Z |
| publishDate | 2020-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-57f56c6671cf4c9dbb3ce67f32f686062022-12-21T18:25:36ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202020-01-0177884485110.2298/VSP180808160T0042-84501800160TInfluence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplantsTodorović-Balint Milena0Bila Jelena1Balint Bela2Jeličić Jelena3Đunić Irena4Antić Darko5Kraguljac-Kurtović Nada6Vujić Dragana7Mihaljević Biljana8Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaSerbian Academy of Science and Arts, Belgrade, Serbia + Institute of Cardiovascular Diseases "Dedinje", Belgrade, Serbia + University of Belgrade, Institute for Medical Research, Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Belgrade, Serbia + Institute for Health Protection of Mother and Child of Serbia "Dr. Vukan Čupić", Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaBackground/Aim. Autologous stem cell transplants (ASCTs) improve the rate of overall survival (OS) in patients with hematological malignancies such as multiple myeloma (MM) after induction chemotherapy, aggressive non-Hodgkin's lymphomas (NHL), and relapsed, chemotherapy- sensitive Hodgkin's lymphoma (HL). The study aim was to evaluate influence of applied CD34+ cell quantity on clinical outcome, as well as early post-transplant and overall survival (OS) of HL and MM patients following ASCT. Methods. This study included a total of 210 patients (90 HL/120 MM) who underwent ASCT. Stem cell (SC) mobilization was accomplished by granulocyte-colony stimulating factor (G-CSF) 10–16 μg/kg body mass (bm) following chemotherapy. For proven poor mobilizers, mobilization with G-CSF (16 μg/kgbm) and Plerixafor (24 or 48 mg) was performed. To our best knowledge, it was the first usage of the Plerixafor in our country in the ASCT-setting. Harvesting was initiated merely at "cut-off-value" of CD34+ cells ≥ 20 × 106/L in peripheral blood with "target-dose" of CD34+ cells ≥ 5 × 106/kgbm in harvest. The CD34+ cell count and viability was determined using flow cytometry. Results. The majority of HL patients (76.7%) were infused with > 5.0 × 106/kgbm CD34+ cells, while 68.3% of MM patients were treated by approximately 4.0–5.4 × 106/kgbm CD34+ dose, respectively. Beneficial response (complete/ partial remission) was achieved in 83.3% (HL) and 94.2% (MM) patients. Among parameters that influenced survival of HL patients with positive response to the therapy, multivariate analysis (pre-ASCT performance status, CD34+ cell quantity applied, rapid hematopoietic, i.e. lymphocyte and platelet recovery) indicated that higher CD34+ cell dose used, along with pre-ASCT performance status correlated with superior event-free survival (EFS) and OS following ASCT. In MM patients, multivariate analysis (renal impairment, infused CD34+ cell quantity, early platelet recovery) indicated that the number of CD34+ cells infused was the most important parameter that influenced both EFS and OS after ASCT. Conclusion. Data obtained in this study undoubtedly confirmed that CD34+ cell dose applied is an independent factor that may contribute to superior clinical outcome and OS of HL and MM patients following ASCT. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 41004 and Grant no. III 41030]http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800160T.pdfhematologic neoplasmsstem cellstransplantation, autologoussurvivalflow cytometry |
| spellingShingle | Todorović-Balint Milena Bila Jelena Balint Bela Jeličić Jelena Đunić Irena Antić Darko Kraguljac-Kurtović Nada Vujić Dragana Mihaljević Biljana Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants Vojnosanitetski Pregled hematologic neoplasms stem cells transplantation, autologous survival flow cytometry |
| title | Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants |
| title_full | Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants |
| title_fullStr | Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants |
| title_full_unstemmed | Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants |
| title_short | Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants |
| title_sort | influence of applied cd34 cell dose on the survival of hodgkin s lymphoma and multiple myeloma patients following autologous stem cell transplants |
| topic | hematologic neoplasms stem cells transplantation, autologous survival flow cytometry |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800160T.pdf |
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