Predictive Factors for Early Immune Recovery in NHL Patients after Autologous Transplantation: A Multicenter Prospective Study
by
,
Anu Partanen
1,*, 
Antti Turunen
1,
Outi Kuittinen
2,3,
Hanne Kuitunen
4,
Pentti Mäntymaa
5,
Ville Varmavuo
6 and
Esa Jantunen
1,2 1
Department of Medicine, Kuopio University Hospital, 70290 Kuopio, Finland
2
Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland
3
Department of Oncology, Kuopio University Hospital, 70290 Kuopio, Finland
4
Cancer Center, Oulu University Hospital, 90220 Oulu, Finland
5
Eastern Finland Laboratory Centre, 70211 Kuopio, Finland
6
Department of Medicine, Kymenlaakso Central Hospital, 48210 Kotka, Finland
*
Author to whom correspondence should be addressed.
Cancers 2024, 16(14), 2550; https://doi.org/10.3390/cancers16142550
Submission received: 13 June 2024
/
Revised: 6 July 2024
/
Accepted: 12 July 2024
/
Published: 16 July 2024
(This article belongs to the Topic Anti-Tumor Immune Responses 2.0)
Simple Summary
Early lymphocyte recovery has been associated with a better outcome after autologous hematopoietic stem cell transplantation in many retrospective studies. Scarce prospective data exist on the detailed factors that correlate with early immune recovery as manifested by the absolute lymphocyte count at day +15 after transplantation and the influence of early immune recovery on outcome in patients with non-Hodgkin lymphoma. This prospective multicenter study aimed to clarify factors linked with early lymphocyte recovery after autologous stem cell transplantation among 178 patients with non-Hodgkin lymphoma. We found that faster early immune recovery was strongly associated with better PFS. Specific cut-offs of mobilization capacity as manifested by peak blood CD34+ cell count as well as CD3+CD4+ T cells, CD3+CD8+ T cells, and NK cells in the infused graft seemed to predict early immune recovery, which is associated with a better outcome in NHL patients after transplantation.
Abstract
Early lymphocyte recovery as manifested by an absolute lymphocyte count at d+15 (ALC-15) ≥ 0.5 × 109/L after autologous hematopoietic stem cell transplantation (AHCT) has been associated with a better outcome. This prospective multicenter study aimed to clarify factors associated with ALC-15 ≥ 0.5 × 109/L after AHCT among 178 patients with non-Hodgkin lymphoma. The mobilization capacity, as manifested by peak blood CD34+ cell numbers > 45 × 106/L correlated with higher ALC-15 levels (p = 0.020). In addition, the amount of CD3+CD4+ T cells > 31.8 × 106/kg in the infused graft predicted ALC-15 ≥ 0.5 × 109/L (p < 0.001). Also, the number of infused graft CD3+CD8+ T cells > 28.8 × 106/kg (p = 0.017) and NK cells > 4.4 × 106/kg was linked with higher ALC-15 (p < 0.001). The two-year progression-free survival after AHCT was significantly better in patients with ALC-15 ≥ 0.5 × 109/L (74 vs. 57%, p = 0.027). The five-year OS in patients with higher ALC-15 was 78% vs. 60% in those with lower ALC-15 (p = 0.136). To conclude, the mobilization capacity of CD34+ cells and detailed measures of graft cellular content mark prognostic tools that predict ALC-15 ≥ 0.5 × 109/L, which is associated with a better outcome in NHL patients after AHCT.
