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Infusion of autograft natural killer cell/CD14+HLA-DRDIM cell ratio predicts survival in lymphoma post autologous stem cell transplantation

Bone Marrow Transplantation volume 53, pages 146–154 (2018)Cite this article

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Abstract

The infusion of autograft absolute lymphocyte count (A-ALC) and autograft natural killer cells (A-NKC) are prognostic factors for overall survival (OS) and PFS in non-Hodgkin’s lymphoma (NHL) patients undergoing autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT). The human monocytic CD14+HLA-DRDIM cells are associated with worse prognosis in NHL. Thus, we investigated whether the autograft A-NKC/A-CD14+HLA-DRDIM ratio predicts survival in NHL. In a total of 111 NHL patients, we analyzed apheresis collection samples for the content of A-NKC and A-CD14+HLA-DRDIM. With a median follow-up of 57.2 months (range: 2.1–84.6 months), patients with an A-NKC/A-CD14+HLA-DRDIM ratio of ⩾0.29 experienced superior OS (5-year OS rates of 84% (95% confidence interval (CI), 72–91%) vs 48% (95% CI, 34–62%), P<0.0002, respectively) and PFS (5-year PFS rates of 59% (95% CI, 47–71%) vs 32% (95% CI, 20–48%), P<0.002, respectively). Multivariate analysis revealed that A-NKC/A-CD14+HLA-DRDIM ratio was an independent predictor for PFS (hazard ratio (HR)=0.56, 95% CI, 0.32–0.96, P<0.03) and OS (HR=0.34, 95% CI, 0.16–0.68, P<0.002). The A-NKC/A-CD14+HLA-DRDIM ratio provides a platform to target specific autograft immune effector cells to improve clinical outcomes in NHL patients undergoing APBHSCT.

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Acknowledgements

This work was partially presented as an oral presentation at the BMT Tandem meeting in Orlando, Florida, on 24 February 2017 under the oral abstracts-session I-Autologous Transplants (Chairs: Dr Emma C Morris and Dr Sergio A Giralt).

Author contributions

AK designed study, analyzed data, wrote the first draft and approved the final version of the manuscript; DJI, SMA, INM, PBJ and WJH performed patient management, revised the manuscript critically and approved the final version of the manuscript; SNM designed study, revised the manuscript critically and approved the final version of the manuscript; and LFP designed study, analyzed data, performed patient management, revised the manuscript critically and approved the final version of the manuscript.

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Authors and Affiliations

  1. Division of Hematology, Mayo Clinic, Rochester, MN, USA

    A Kansagra, D J Inwards, S M Ansell, I N Micallef, P B Johnston, W J Hogan & L F Porrata

  2. Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA

    S N Markovic

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  1. A Kansagra
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  2. D J Inwards
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  3. S M Ansell
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  4. I N Micallef
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Correspondence to L F Porrata.

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Kansagra, A., Inwards, D., Ansell, S. et al. Infusion of autograft natural killer cell/CD14+HLA-DRDIM cell ratio predicts survival in lymphoma post autologous stem cell transplantation. Bone Marrow Transplant 53, 146–154 (2018). https://doi.org/10.1038/bmt.2017.225

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