Diffuse large B-cell lymphoma (DLBCL) patients infused with an autograft absolute lymphocyte count (A-ALC) have superior survival following autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT), according to a study published in Transplantation and Cellular Therapy.
In this double phase III trial, researchers used the GREEDY algorithm to assess 85 DLBCL patients (cases) infused with an A-ALC ≥ 0.5 × 109 cells/kg, after April 2017, and matched them in a 1:1:1 ratio with control groups of DLBCL patients transplanted prior to April 2017. Control 1 comprised patients infused with an A-ALC < 0.5 × 109 cells/kg, while control 2 consisted of patients infused with an A-ALC ≥ 0.5 × 109 cells/kg. The two groups were matched based on gender, age, stage, lactate dehydrogenase (LDH), performance status, extra-nodal disease, international prognostic index (IPI), and disease status prior to APBHSCT, characterized by either complete response or partial response.
According to the results, cases, and control 2 demonstrated superior overall survival (OS) and progression-free survival (PFS) compared with control 1. Multivariate analysis showed that A-ALC ≥ 0.5 × 109 cells/kg as an independent predictor for OS (HR=0.382, 95% CI, 0.241-0.605) and PFS (HR=0.437, 95% CI, 0.279-0.629).
“Our match-control study continues to support the results of published retrospective studies and our Phase III study showing that the infusion of A-ALC is a prognostic factor for survival of DLBCL patients undergoing APBHSCT,” the researchers concluded. They added that the findings “support the practice of not only collecting enough stem cells for hematologic engraftment, but also enough immune effector cells (i.e., A-ALC) to improve clinical outcomes in DLBCL patients post-APBHSCT.”
Keywords: Autograft absolute lymphocyte count, Autologous peripheral blood hematopoietic stem cell transplantation, Diffuse large B-cell Lymphoma