University of Oulu

Turunen, A, Silvennoinen, R, Partanen, A, et al. Autograft cellular composition and outcome in myeloma patients: Results of the prospective multicenter GOA study. Transfusion. 2021; 61: 1830– 1844.

Autograft cellular composition and outcome in myeloma patients : results of the prospective multicenter GOA study

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Author: Turunen, Antti1,2; Silvennoinen, Raija1,3; Partanen, Anu1;
Organizations: 1Department of Medicine, Kuopio University Hospital, Kuopio, Finland
2Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
3Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4Department of Medicine, Oulu University Hospital, Oulu, Finland
5Department of Medicine, Turku University Hospital, Turku, Finland
6Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
7Finnish Medicines Agency, Kuopio, Finland
8Department of Medicine, Savonlinna Central Hospital, Savonlinna, Finland
9Department of Medicine, Central Hospital of Central Finland, Jyväskylä, Finland
10Nordlab, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
11Laboratory Centre of Eastern Finland, Kuopio, Finland
12Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
13Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
14Department of Medicine, North Carelia Hospital District, Joensuu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.8 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2022-01-17


Background: Autologous stem cell transplantation (auto-SCT) is a widely used treatment option in multiple myeloma (MM) patients. The optimal graft cellular composition is not known.

Study design and methods: Autograft cellular composition was analyzed after freezing by flow cytometry in 127 MM patients participating in a prospective multicenter study. The impact of graft cellular composition on hematologic recovery and outcome after auto-SCT was evaluated.

Results: A higher graft CD34⁺ cell content predicted faster platelet recovery after auto-SCT in both the short and long term. In patients with standard-risk cytogenetics, a higher graft CD34⁺ count (<2.5 × 10⁶/kg) was linked with shorter progression-free survival (PFS; 28 vs. 46 months, p = 0.04), but there was no difference in overall survival (OS) (p = 0.53). In a multivariate model, a higher graft CD34⁺CD133⁺CD38⁻ (>0.065 × 10⁶/kg, p = 0.009) and NK cell count (%gt;2.5 × 10⁶/kg, p = 0.026), lenalidomide maintenance and standard-risk cytogenetics predicted better PFS. In contrast, a higher CD34+ count (>2.5 × 10⁶/kg, p = 0.015) predicted worse PFS. A very low CD3⁺ cell count (≤20 × 10⁶/kg, p = 0.001) in the infused graft and high-risk cytogenetics remained predictive of worse OS.

Conclusions: Autograft cellular composition may impact outcome in MM patients after auto-SCT. More studies are needed to define optimal graft composition.

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Series: Transfusion
ISSN: 0041-1132
ISSN-E: 1537-2995
ISSN-L: 0041-1132
Volume: 61
Issue: 6
Pages: 1830 - 1844
DOI: 10.1111/trf.16424
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: Cancer Fund of North Savo; North Savo Hospital District EVO Fund; North Savo Hospital District Research Fund; North Savo Hospital District VTR Fund; The Finnish Medical Foundation; The Finnish Society of Hematology; Blood Disease Research Foundation; Sanofi Genzyme.
Copyright information: © 2021 The Authors. Transfusion published by Wiley Periodicals LLC. on behalf of AABB. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.