Effects of infused CD34 + cell count on hematopoietic recovery and prognosis of non-Hodgkin lymphoma patients after autologous peripheral blood hematopoietic stem cell transplantation
10.3760/cma.j.cn115356-20190617-00117
- VernacularTitle:移植物CD34 +细胞数对自体外周血造血干细胞移植后非霍奇金淋巴瘤患者造血重建及预后的影响
- Author:
Jin ZHAO
1
;
Liping SU
;
Tao GUAN
;
Jiangtao WANG
;
Xiaolan LIU
;
Li MA
;
Jingrong WANG
Author Information
1. 山西医科大学附属山西省肿瘤医院血液科，太原 030013
- From:
Journal of Leukemia & Lymphoma
2020;29(3):165-169
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of infused CD34 + cell count on hematopoietic recovery and prognosis of non-Hodgkin lymphoma (NHL) patients after autologous peripheral blood hematopoietic stem cell transplantation (APBSCT). Methods:The data of 60 NHL patients who underwent APBSCT from May 2010 to May 2016 in the Affiliated Cancer Hospital of Shanxi Medical University was retrospectively analyzed, including 32 B-NHL patients and 28 T-NHL patients. The patients were grouped according to the receiver operating characteristic curve (ROC) threshold, and the hematopoietic reconstruction after transplantation was analyzed. The relationship between the infused CD34 + cell count and prognosis was analyzed. The prognostic factors were analyzed using univariate and multivariate analyses. Results:The CD34 + cell count threshold was determined to be 4.35×10 6/kg based on ROC. In CD34 + cell count≥ 4.35×10 6/kg group (20 cases) and CD34 + cell count < 4.35×10 6/kg group (40 cases), the granulocyte recovery time was (9.9±1.2) d and (12.5±3.7) d ( P = 0.031), and the platelet recovery time was (9.4±1.7) d and (13.8±2.9) d ( P = 0.012). The 3-year overall survival(OS) rates in CD34 + cell count ≥ 4.35×10 6/kg group and CD34 + cell count < 4.35×10 6/kg group were 85.0% and 55.0% ( P = 0.024), and the 3-year PFS rates were 85.0% and 57.5% ( P = 0.016). In B-NHL patients, the 3-year PFS rates in CD34 + cell count ≥ 4.35×10 6/kg group (11 cases) and CD34 + cell count < 4.35×10 6/kg group (21 cases) were 81.8% and 42.9% ( P = 0.037), respectively. In T-NHL patients, the 3-year OS rates in CD34 + cell count ≥ 4.35×10 6/kg group (9 cases) and CD34 + cell count < 4.35×10 6/kg group (19 cases) were 77.8% and 36.8% ( P = 0.049), respectively. Univariate survival analysis showed that the predictive factors of both OS and PFS included age > 60 years old, Ann Arbor stage Ⅲ-Ⅳ, international prognostic index (IPI) score > 2 and infused CD34 + cell count < 4.35×10 6/kg (all P < 0.05). Multivariate analysis showed that IPI score and infused CD34 + cell count were both independent predictive factors of PFS ( RR = 0.333, 95% CI 0.112-0.994, P = 0.049; RR = 0.190, 95% CI 0.047-0.773, P = 0.020), and IPI score was an independent predictive factor of OS ( RR = 0.095, 95% CI 0.011-0.837, P = 0.034). Conclusion:The infused CD34 + cell count affects the hematopoietic reconstruction time and component blood transfusion after APBSCT, and has certain predictive value for the prognosis of NHL patients.
