Predictive role of levels of soluble interleukin-2 receptor and C-reactive protein in selecting autologous PBSC transplantation for lymphoma

Abstract

High-dose chemotherapy (HDC) followed by autologous peripheral blood stem cell transplantation (HDC-auto-PBSCT) offers a cure for patients with lymphoma without the risk of GVHD. Conditioning regimens for Auto-SCT administered to patients in major studies have included BCNU in the BEAM or BEAC (BCNU, etoposide, cytarabine and cyclophosphamide) regimens. 1 However, BCNU is not available in Japan; therefore, various alternative regimens using ranimustine (MCNU) have been developed. An HDC regimen with MCNU, carboplatin, etoposide and cyclophosphamide (MCEC), which was first published by the Fukuoka Bone Marrow Transplantation Group, 2 has been widely used as a conditioning regimen for auto-PBSCT for non-Hodgkin lymphoma in Japan. [3][4][5] Multicenter trials have published the outcomes of the MCEC regimen, but only limited information is available with regard to prognostic factors (particularly laboratory parameters) for HDC-auto-PBSCT with the MCEC regimen. 4,5 Therefore, to establish predictive models for selecting appropriate therapeutic strategies, we retrospectively evaluated pre-transplantation factors that correlate with post-transplantation survival among patients with non-Hodgkin lymphoma who received first auto-PBSCT with the MCEC regimen as a historical cohort study.Patients who had received the MCEC regimen, which consisted of MCNU 200 mg/m 2 on days − 8 and − 3, carboplatin 300 mg/m 2 from days − 7 to − 4, etoposide 500 mg/m 2 from days − 6 to − 4 and cyclophosphamide 60 mg/kg on days − 3 and − 2, as arranged of which was described previously, 2,3 between August 1999 and December 2012 at Showa University Hospital, were enrolled. Responses to first-line chemotherapy, prior to chemotherapy of HDC-auto-PBSCT, and HDC-auto-PBSCT themselves were judged according to the International Working Group response criteria without evaluation using positron emission tomographycomputed tomography findings. 6 The responses to prior chemotherapies of HDC-auto-PBSCT were defined as disease status at SCT (CR as CR or CR/unconfirmed [CRu]; non-CR as less than CRu) and chemosensitivity at SCT (chemosensitive as CR, CRu or PR; chemoresistant as less than PR). Pre-transplantation factors, the prognostic impacts of most of which have been reported previously, were evaluated using univariate and multivariate analyses. The factors included laboratory parameters before HDC-auto-PBSCT, which were defined as the values determined between the latest chemotherapy end date and the administration of MCEC conditioning. All P values were determined from 2-tailed tests, with P o 0.05 considered significant. All statistical analyses were performed using EZR version 1.24 (Kanda Y, Saitama Medical Center, Jichi Medical University, Saitama, Japan). The study protocol was approved by the Ethics Committee of Showa University (Tokyo, Japan), which adhered to the principles of the Declaration of Helsinki.Thirty-eight patients (25 males and 13 females) with non-Hodgkin lymphoma who received the MCEC regimen because of non-CR achievement by first-...

The Karolinska experience of autologous stem-cell transplantation for lymphoma: a population-based study of all 433 patients 1994–2016

“…We also show that dynamic measurements of inflammation and poor health, such as CRP [22], albumin, and creatinine are important for TRM. It has long been known that stem-cell doses ≥ 5 million CD34 + cells/kg correlate with improved resource utilization [23].…”

Comprehensive serum cytokine analysis identifies IL-1RA and soluble IL-2Rα as predictors of event-free survival in T-cell lymphoma

“…These serum cytokine abnormalities are certainly not unique to TCL, but have been described in other types of B-cell NHL [13,15], Waldenstrom's macroglobulinemia [16], and HL [17]. Specifically, sIL-2R levels have been shown to predict the outcome in patients undergoing autologous stem cell transplant for B-cell NHL [31]. Recent studies of pretreatment of sIL-2R in patients with untreated diffuse large B-cell lymphoma treated with modern RCHOP-based regimens demonstrated that high levels of sIL-2R were predictive of an inferior OS [32][33][34].…”