title: CD34+ selected versus unselected autologous stem cell transplantation in patients with advanced-stage mantle cell and diffuse large B-cell lymphoma.
abstract: Novel strategies aiming to increase survival rates in patients with advanced-stage mantle cell lymphoma (MCL) and relapsing diffuse large B-cell lymphoma (DLBCL) are a clinical need. High-dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) has improved progression-free (PFS) and overall survival (OS) in MCL and relapsed DLBCL. However, the role of CD34+ cell selection before ASCT in MCL and DLBCL is unclear. We retrospectively analyzed the outcome of 62 consecutive patients with advanced-stage MCL or relapsed DLBCL undergoing ASCT with (n=31) or without (n=31) prior CD34+ selection. All patients had stage III or IV disease, with 47% having DLBCL and 53% MCL. The median duration for neutrophil and platelet recovery was 12 and 16 days in CD34+ selected patients, and 11 (P<.001) and 14 days (P=.012) in the group without selection, respectively. No differences in toxicities were observed. The 5-year PFS for CD34+ selected versus not selected patients was 67% and 39% (P=.016), and the 5-year OS was 86% and 54% (P=.007). Our data suggest that using CD34+ selected autografts for ASCT in advanced stage MCL and DLBCL is associated with longer PFS and OS without increased toxicity.
authors.affiliation: Department of Medical Oncology, University Hospital and University of Berne, Berne, Switzerland.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Berger
authors.affiliation: Department of Medical Oncology, University Hospital and University of Berne, Berne, Switzerland.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Branger
authors.affiliation: Department of Pediatrics, University Hospital and University of Berne, Berne, Switzerland.
authors.forename: Kurt
authors.initials: K
authors.lastname: Leibundgut
authors.affiliation: Department of Hematology, University Hospital and University of Berne, Berne, Switzerland.
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Baerlocher
authors.affiliation: Department of Clinical Research, University Hospital and University of Berne, Berne, Switzerland.
authors.forename: Katja
authors.initials: K
authors.lastname: Seipel
authors.affiliation: Department of Clinical Research, University Hospital and University of Berne, Berne, Switzerland.
authors.forename: Beatrice U
authors.initials: BU
authors.lastname: Mueller
authors.affiliation: Department of Hematology, Kantonsspital, Lucerne, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Gregor
authors.affiliation: Department of Hematology, Kantonsspital, Lucerne, Switzerland.
authors.forename: Axel
authors.initials: A
authors.lastname: Ruefer
authors.affiliation: Department of Medical Oncology, University Hospital and University of Berne, Berne, Switzerland; Department of Clinical Research, University Hospital and University of Berne, Berne, Switzerland. Electronic address: thomas.pabst@insel.ch.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pabst
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34; D064592:Autografts; D018572:Disease-Free Survival; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality* / Q000628:therapy*; D020522:Lymphoma, Mantle-Cell / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation / Q000379:methods*; D015996:Survival Rate
chemical_list: D018952:Antigens, CD34
keywords: Autologous transplantation; CD34 selection; Diffuse large B-cell lymphoma; Mantle cell lymphoma; Outcome; Purging; Stem cell; Survival