Mobilization Characteristics, Blood Graft Composition, And Outcome In Diffuse Large B-Cell Lymphoma After Autologous Stem Cell Transplantation: Results From The Prospective Multicenter Goa Study

Background Diffuse large B-cell lymphoma (DLBCL) is a common indication for autologous stem cell transplantation (auto-SCT).Study Design and Methods This prospective noninterventional study aimed to evaluate the impact of mobilization characteristics and graft cellular content on hematologic recovery and outcome after auto-SCT among 68 patients with DLBCL.Results Better mobilization capacity as manifested by blood CD34(+) cell count >32 x 10(6)/L and CD34(+) cell yield of the first apheresis >2.75 x 10(6)/kg correlated with faster neutrophil (P = .005 and P = .017) and platelet (P = .002 and P < .001) recovery. A higher number of infused CD34(+) cells (> 2.65 x 10(6)/kg) was associated with better 5-year overall survival (OS; 95% vs 67%, P = .012). The graft CD34(+)CD133(+)CD38(-) cell count >0.07 x 10(6)/kg was predictive of better 5-year OS (87% vs 63%; P = .008) and higher graft CD3(+) cell count (>23.1 x 10(6)/kg) correlated also with better 5-year OS (80% vs 40%, P = .008). In multivariate analysis only disease status of CR I at auto-SCT was associated with better progression-free survival (P = .014) and OS (P = .039).Conclusion The mobilization capacity of CD34(+) cells impacted on early hematologic recovery in patients with DLBCL after auto-SCT. Higher graft CD34(+) cell count and both CD34(+)CD133(+)CD38(-) and CD3(+) cells were also associated with better OS. The effect of optimal graft cellular composition on outcome in DLBCL should be evaluated in a randomized study.