J Hematol

Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc

Journal website https://www.thejh.org

Original Article

Volume 10, Number 6, December 2021, pages 246-254

Blood Graft and Outcome After Autologous Stem Cell Transplantation in Patients With Primary Central Nervous System Lymphoma

Figure 1. Progression-free survival in 17 patients with PCNSL. PCNSL: primary central nervous system lymphoma.

**Table 1.** Patient and Mobilization Characteristics in Patients With PCNS Lymphoma
Variables	n = 17
^aMissing data in two patients. ^bMissing data in three patients. BBBD: blood and brain barrier disruption including therapy with intra-arterial mannitol infusion followed by methotrexate and carboplatin and intravenous rituximab, etoposide and cyclophosphamide; Bonn protocol: methotrexate and cytarabine-based chemotherapy; CR: complete remission; CSF: cerebrospinal fluid; DHAP: dexamethasone-cytarabine-cisplatin; FIL: filgrastim; G-CSF: granulocyte colony-stimulating factor; HD-AraC: high-dose cytarabine; LDH: lactate dehydrogenase; LIPEG: lipegfilgrastim; MATRix: methotrexate-cytarabine-thiotepa-rituximab; PCNS: primary central nervous system; PEG: pegfilgrastim; PLER: plerixafor; PR: partial remission; pre-auto-SCT: before autologous stem cell transplantation.
Gender
Female	10 (59)
Male	7 (41)
Age at auto-SCT, years, median (range)	62 (45 - 73)
LDH serum level at diagnosis^a
Normal	10 (59)
Elevated	5 (29)
CSF protein concentration at diagnosis^b
Normal	8 (47)
Elevated	6 (35)
Involvement of deep region of the brain at diagnosis
No	7 (41)
Yes	10 (59)
Mobilization chemotherapy
BBBD	11 (64)
Bonn block	2 (12)
MATRix	2 (12)
HD-AraC	1 (6)
DHAP	1 (6)
G-CSF used in mobilization
FIL	11 (65)
PEG	4 (23)
LIPEG	2 (12)
Disease status pre-auto-SCT
I CR	14 (82)
I PR	3 (18)
PLER use, n (%)	7 (41)

Table 1. Patient and Mobilization Characteristics in Patients With PCNS Lymphoma

Variables

n = 17

^aMissing data in two patients. ^bMissing data in three patients. BBBD: blood and brain barrier disruption including therapy with intra-arterial mannitol infusion followed by methotrexate and carboplatin and intravenous rituximab, etoposide and cyclophosphamide; Bonn protocol: methotrexate and cytarabine-based chemotherapy; CR: complete remission; CSF: cerebrospinal fluid; DHAP: dexamethasone-cytarabine-cisplatin; FIL: filgrastim; G-CSF: granulocyte colony-stimulating factor; HD-AraC: high-dose cytarabine; LDH: lactate dehydrogenase; LIPEG: lipegfilgrastim; MATRix: methotrexate-cytarabine-thiotepa-rituximab; PCNS: primary central nervous system; PEG: pegfilgrastim; PLER: plerixafor; PR: partial remission; pre-auto-SCT: before autologous stem cell transplantation.

Gender

Female

10 (59)

Male

7 (41)

Age at auto-SCT, years, median (range)

62 (45 - 73)

LDH serum level at diagnosis^a

Normal

10 (59)

Elevated

5 (29)

CSF protein concentration at diagnosis^b

Normal

8 (47)

Elevated

6 (35)

Involvement of deep region of the brain at diagnosis

7 (41)

Yes

10 (59)

Mobilization chemotherapy

BBBD

11 (64)

Bonn block

2 (12)

MATRix

2 (12)

HD-AraC

1 (6)

DHAP

1 (6)

G-CSF used in mobilization

FIL

11 (65)

PEG

4 (23)

LIPEG

2 (12)

Disease status pre-auto-SCT

I CR

14 (82)

I PR

3 (18)

PLER use, n (%)

7 (41)

**Table 2.** Mobilization and Collection Parameters for CD34⁺ Cells in Patients With PCNS Lymphoma
Variables	n = 17
PCNS: primary central nervous system; WBC: white blood cell.
WBC count (× 10⁹/L) at the time of the first apheresis, median (range)	32.9 (4.8 - 116.2)
Blood CD34⁺ cell count (× 10⁶/L) at the first apheresis, median (range)	43 (7 - 139)
Peak blood CD34⁺ cell count (× 10⁶/L), median (range)	43 (11 - 139)
CD34⁺ cell yield (× 10⁶/kg) of the first apheresis, median (range)	2.5 (0.6 - 6.9)
Total collected CD34⁺ cell yield (× 10⁶/kg), median (range)	3.7 (2.3 - 6.9)
Number of aphereses (%)
1	9 (53)
2	3 (19)
3	2 (12)
4	3 (19)

Table 2. Mobilization and Collection Parameters for CD34⁺ Cells in Patients With PCNS Lymphoma

Variables

n = 17

PCNS: primary central nervous system; WBC: white blood cell.

WBC count (× 10⁹/L) at the time of the first apheresis, median (range)

32.9 (4.8 - 116.2)

Blood CD34⁺ cell count (× 10⁶/L) at the first apheresis, median (range)

43 (7 - 139)

Peak blood CD34⁺ cell count (× 10⁶/L), median (range)

43 (11 - 139)

CD34⁺ cell yield (× 10⁶/kg) of the first apheresis, median (range)

2.5 (0.6 - 6.9)

Total collected CD34⁺ cell yield (× 10⁶/kg), median (range)

3.7 (2.3 - 6.9)

Number of aphereses (%)

9 (53)

3 (19)

2 (12)

3 (19)

**Table 3.** Cellular Composition of Infused Grafts in Patients With PCNS Lymphoma
Variables (× 10⁶/kg), median (range)	n = 10
PCNS: primary central nervous system; 7-AAD: 7-aminoactinomycin; NK: natural killer.
CD34⁺ cells without 7-AAD	3.6 (1.5 - 5.3)
CD34⁺ cells with 7-AAD	2.1 (0.9 - 5.1)
CD34⁺CD133⁺CD38^- cells	0.07 (0.011 - 0.17)
CD3⁺ cells	113.2 (67.5 - 253.4)
CD3⁺CD4⁺ cells	69.6 (39.5 - 164.1)
CD3⁺CD8⁺ cells	41.5 (25.2 - 187.2)
CD4⁺/CD8⁺	1.6 (0.4 - 4.3)
CD19⁺ cells	0 (0 - 0.3)
NK cells	8.5 (1 - 22.9)

Table 3. Cellular Composition of Infused Grafts in Patients With PCNS Lymphoma

Variables (× 10⁶/kg), median (range)

n = 10

PCNS: primary central nervous system; 7-AAD: 7-aminoactinomycin; NK: natural killer.

CD34⁺ cells without 7-AAD

3.6 (1.5 - 5.3)

CD34⁺ cells with 7-AAD

2.1 (0.9 - 5.1)

CD34⁺CD133⁺CD38^- cells

0.07 (0.011 - 0.17)

CD3⁺ cells

113.2 (67.5 - 253.4)

CD3⁺CD4⁺ cells

69.6 (39.5 - 164.1)

CD3⁺CD8⁺ cells

41.5 (25.2 - 187.2)

CD4⁺/CD8⁺

1.6 (0.4 - 4.3)

CD19⁺ cells

0 (0 - 0.3)

NK cells

8.5 (1 - 22.9)

**Table 4.** Correlation Between Graft Cellular Composition and Hematologic Recovery After Auto-SCT
Variables	CD34⁺ w 7-AAD	CD3⁺	CD3⁺CD4⁺	CD3⁺CD8⁺	CD34⁺CD38	NK
*P values are statistically significant (< 0.05). CD34⁺ w 7-AAD: CD34⁺ with 7-aminoactinomycin; r: Spearman correlation coefficient; PLT: platelet; WBC: white blood cell; auto-SCT: autologous stem cell transplantation; NK: natural killer.
Blood count 15 days after auto-SCT
WBCs (× 10⁹/L)	0.491	NS	-0.430	NS	-0.236	NS	-0.685	0.029*	0.624	NS	0.006	NS
Neutrophils (× 10⁹/L)	0.714	0.047*	-0.762	0.028	-0.476	NS	-0.905	0.002*	0.643	NS	0.048	NS
Lymphocytes (× 10⁹/L)	0.486	NS	-0.429	NS	-0.600	NS	-0.314	NS	0.600	NS	-0.771	NS
PLTs (× 10⁹/L)	0.685	0.029*	-0.709	0.022*	-0.503	NS	-0.818	0.004*	0.418	NS	0.067	NS
Blood count 1 month after auto-SCT
Hb (g/L)	0.455	NS	-0.745	0.013*	-0.685	0.029*	-0.806	0.005*	0.539	NS	-0.212	NS
WBCs (× 10⁹/L)	0.164	NS	0.091	NS	-0.115	NS	-0.115	NS	0.139	NS	0.006	NS
Neutrophils (× 10⁹/L)	0.576	NS	-0.685	0.029*	-0.600	NS	-0.661	0.038*	0.006	NS	-0.030	NS
Lymphocytes (× 10⁹/L)	-0.285	NS	0.628	NS	0.310	NS	0.485	NS	0.033	NS	-0.042	NS
PLTs (× 10⁹/L)	0.467	NS	-0.406	NS	-0.430	NS	-0.442	NS	0.091	NS	0.200	NS
Blood count 3 months after auto-SCT
Hb (g/L)	0.326	NS	-0.603	NS	-0.803	0.009*	-0.494	NS	0.142	NS	-0.452	NS
WBCs (× 10⁹/L)	0.418	NS	-0.326	NS	-0.326	NS	-0.176	NS	-0.025	NS	0.159	NS
Neutrophils (× 10⁹/L)	0.335	NS	-0.109	NS	0.025	NS	-0.075	NS	0.084	NS	0.385	NS
Lymphocytes (× 10⁹/L)	-0.067	NS	0.008	NS	-0.293	NS	0.377	NS	-0.226	NS	-0.151	NS
PLTs (× 10⁹/L)	0.533	NS	-0.433	NS	-0.383	NS	-0.583	NS	-0.050	NS	0.317	NS
Blood count 6 months after auto-SCT
Hb (g/L)	0.217	NS	-0.167	NS	-0.400	NS	-0.317	NS	0.217	NS	-0.433	NS
WBCs (× 10⁹/L)	0.217	NS	-0.117	NS	-0.267	NS	-0.217	NS	-0.200	NS	0.083	NS
Neutrophils (× 10⁹/L)	0.288	NS	0.198	NS	0.036	NS	0.090	NS	-0.090	NS	0.505	NS
Lymphocytes (× 10⁹/L)	0.174	NS	-0.696	NS	-0.464	NS	-0.551	NS	-0.290	NS	-0.058	NS
PLTs (× 10⁹/L)	0.183	NS	-0.183	NS	-0.400	NS	-0.217	NS	-0.517	NS	-0.100	NS
Blood count 12 months after auto-SCT
Hb (g/L)	0.552	NS	-0.494	NS	-0.603	NS	-0.226	NS	0.636	NS	-0.075	NS
WBCs (× 10⁹/L)	-0.050	NS	0.133	NS	-0.117	NS	0.017	NS	-0.333	NS	-0.283	NS
Neutrophils (× 10⁹/L)	0.195	NS	0.366	NS	0.073	NS	0.342	NS	0.122	NS	0.024	NS
Lymphocytes (× 10⁹/L)	-0.539	NS	0.946	< 0.001*	0.743	0.035*	0.431	NS	-0.431	NS	-0.228	NS
PLTs (× 10⁹/L)	0.233	NS	0.050	NS	-0.017	NS	-0.167	NS	-0.367	NS	0.333	NS

Table 4. Correlation Between Graft Cellular Composition and Hematologic Recovery After Auto-SCT

Variables

CD34⁺ w 7-AAD

CD3⁺

CD3⁺CD4⁺

CD3⁺CD8⁺

CD34⁺CD38

*P values are statistically significant (< 0.05). CD34⁺ w 7-AAD: CD34⁺ with 7-aminoactinomycin; r: Spearman correlation coefficient; PLT: platelet; WBC: white blood cell; auto-SCT: autologous stem cell transplantation; NK: natural killer.

Blood count 15 days after auto-SCT

WBCs (× 10⁹/L)

0.491

-0.430

-0.236

-0.685

0.029*

0.624

0.006

Neutrophils (× 10⁹/L)

0.714

0.047*

-0.762

0.028

-0.476

-0.905

0.002*

0.643

0.048

Lymphocytes (× 10⁹/L)

0.486

-0.429

-0.600

-0.314

0.600

-0.771

PLTs (× 10⁹/L)

0.685

0.029*

-0.709

0.022*

-0.503

-0.818

0.004*

0.418

0.067

Blood count 1 month after auto-SCT

Hb (g/L)

0.455

-0.745

0.013*

-0.685

0.029*

-0.806

0.005*

0.539

-0.212

WBCs (× 10⁹/L)

0.164

0.091

-0.115

0.139

0.006

Neutrophils (× 10⁹/L)

0.576

-0.685

0.029*

-0.600

-0.661

0.038*

0.006

-0.030

Lymphocytes (× 10⁹/L)

-0.285

0.628

0.310

0.485

0.033

-0.042

PLTs (× 10⁹/L)

0.467

-0.406

-0.430

-0.442

0.091

0.200

Blood count 3 months after auto-SCT

Hb (g/L)

0.326

-0.603

-0.803

0.009*

-0.494

0.142

-0.452

WBCs (× 10⁹/L)

0.418

-0.326

-0.176

-0.025

0.159

Neutrophils (× 10⁹/L)

0.335

-0.109

0.025

-0.075

0.084

0.385

Lymphocytes (× 10⁹/L)

-0.067

0.008

-0.293

0.377

-0.226

-0.151

PLTs (× 10⁹/L)

0.533

-0.433

-0.383

-0.583

-0.050

0.317

Blood count 6 months after auto-SCT

Hb (g/L)

0.217

-0.167

-0.400

-0.317

0.217

-0.433

WBCs (× 10⁹/L)

0.217

-0.117

-0.267

-0.217

-0.200

0.083

Neutrophils (× 10⁹/L)

0.288

0.198

0.036

0.090

-0.090

0.505

Lymphocytes (× 10⁹/L)

0.174

-0.696

-0.464

-0.551

-0.290

-0.058

PLTs (× 10⁹/L)

0.183

-0.183

-0.400

-0.217

-0.517

-0.100

Blood count 12 months after auto-SCT

Hb (g/L)

0.552

-0.494

-0.603

-0.226

0.636

-0.075

WBCs (× 10⁹/L)

-0.050

0.133

-0.117

0.017

-0.333

-0.283

Neutrophils (× 10⁹/L)

0.195

0.366

0.073

0.342

0.122

0.024

Lymphocytes (× 10⁹/L)

-0.539

0.946

< 0.001*

0.743

0.035*

0.431

-0.431

-0.228

PLTs (× 10⁹/L)

0.233

0.050

-0.017

-0.167

-0.367

0.333