Blood Cancer Journal (Oct 2024)

Optimal infused CD34+ cell dose in multiple myeloma patients undergoing upfront autologous hematopoietic stem cell transplantation

  • Oren Pasvolsky,
  • Curtis Marcoux,
  • Denái R. Milton,
  • Babar Pal,
  • Mark R. Tanner,
  • Qaiser Bashir,
  • Samer Srour,
  • Jaehyun Lee,
  • Neeraj Saini,
  • Paul Lin,
  • Jeremy Ramdial,
  • Yago Nieto,
  • Guilin Tang,
  • Yosra Aljawai,
  • Partow Kebriaei,
  • Melody R. Becnel,
  • Hans C. Lee,
  • Krina K. Patel,
  • Sheeba K. Thomas,
  • Robert Z. Orlowski,
  • Elizabeth J. Shpall,
  • Richard E. Champlin,
  • Muzaffar H. Qazilbash

DOI
https://doi.org/10.1038/s41408-024-01165-w
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 8

Abstract

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Abstract Autologous transplantation remains the standard of care for eligible multiple myeloma (MM) patients, yet optimal CD34+ cell dose remains unclear. We conducted a retrospective study on MM patients undergoing upfront transplant between 2005 and 2021 and divided them into low (≤2.5 × 106 cells/kg) and high (>2.5 × 106 cells/kg) CD34+ dose groups. We included 2479 patients, 95 in the low CD34+ group and 2384 in the high CD34+ group. Patients in the low CD34+ group were older (63.2 vs 61.1 years, p = 0.013), more often had R-ISS III (19% vs 9%, p = 0.014), received plerixafor (60% vs 35%, p 2.5 × 106 cells/kg. Multivariable analysis affirmed that CD34+ >2.5 × 106 cells/kg was associated with better PFS (HR 0.71, p = 0.008) and OS (0.59, p 2.5 × 106 cells/kg remained a predictor of better OS (0.42, p 2.5 × 106 cells/kg was associated with improved survival, without any additional benefit at incrementally higher doses.