Effects of infused CD34 + cell count on hematopoietic recovery and prognosis of non-Hodgkin lymphoma patients after autologous peripheral blood hematopoietic stem cell transplantation / 白血病·淋巴瘤

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.