Effects of infused CD34+ cell count on hematopoietic recovery and prognosis of non-Hodgkin lymphoma patients after autologous peripheral blood hematopoietic stem cell transplantation

Pub Date : 2020-03-25 DOI:10.3760/CMA.J.CN115356-20190617-00117

Jin Zhao, L. Su, T. Guan, Jiangtao Wang, Xiaolan Liu, Li Ma

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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 4.35×106/kg based on ROC. In CD34+ cell count≥ 4.35×106/kg group (20 cases) and CD34+ cell count 60 years old, Ann Arbor stage Ⅲ-Ⅳ, international prognostic index (IPI) score > 2 and infused CD34+ cell count < 4.35×106/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. Key words: Lymphoma, non-Hodgkin; Autologous hematopoietic stem cell transplantation; CD34+ cell count

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输注CD34+细胞计数对非霍奇金淋巴瘤患者自体外周血造血干细胞移植后造血恢复及预后的影响

目的探讨CD34+细胞计数对非霍奇金淋巴瘤（NHL）患者自体外周血造血干细胞移植（APBSCT）后造血功能恢复及预后的影响。方法回顾性分析2010年5月至2016年5月在山西医科大学附属癌症医院接受APBSCT的60例NHL患者的资料，其中B-NHL患者32例，T-NHL患者28例。根据受试者操作特征曲线（ROC）阈值对患者进行分组，并分析移植后的造血重建情况。分析输注CD34+细胞计数与预后的关系。预后因素采用单因素和多因素分析。结果根据ROC测定CD34+细胞计数阈值为4.35×106/kg。106／kg组（20例）和60岁Ann ArborⅢ～Ⅳ期CD34＋细胞，国际预后指数（IPI）评分>2，输注CD34+细胞计数<4.35×106/kg（均P<0.05）。多因素分析显示，IPI评分和输注CD34+-细胞计数均为PFS的独立预测因素（RR=0.33，95%CI 0.112-0.994，P=0.049；RR=0.190，95%CI 0.047-0.773，P=0.020），IPI评分是OS的独立预测因素（RR=0.095，95%CI0.011-0.837，P=0.034）。结论输注CD34+细胞计数影响APBSCT后造血重建时间和成分输血，对NHL患者的预后有一定的预测价值。关键词：淋巴瘤，非霍奇金；自体造血干细胞移植；CD34+细胞计数

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