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Infused CD34+ cell dose, but not tumour cell content of peripheral blood progenitor cell grafts, predicts clinical outcome in patients with diffuse large B‐cell lymphoma and follicular lymphoma grade 3 treated with high‐dose therapy

Previously, we have shown that patients with diffuse large B‐cell lymphoma (DLBCL) transplanted with contaminated bone marrow (BM) generally have a poor outcome. Whether this is also the case when peripheral blood progenitor cell (PBPC) grafts are used is not known. Forty‐three patients with chemosensitive DLBCL or follicular lymphoma grade 3 (FLgr3) were treated with high‐dose therapy (HDT) and autologous stem cell support. Nine patients received purged grafts. Quantitative real‐time polymerase chain reaction (QRT‐PCR) for either the BCL2/IgH translocation or allele specific oligonucleotide (ASO) QRT‐PCR for the immunoglobulin heavy chain (IgH) complementarity‐determining region 3 were used. Nine of 25 (36%) PBPC grafts contained tumour cells as tested by QRT‐PCR, including two grafts purged by CD34+ cell enrichment combined with B‐cell depletion. The level of contamination of the PBPC/CD34+ cells ranged from 0 to 8·28%. No relationship could be shown between the total number of tumour cells infused and relapse. Patients receiving PCR‐positive or PCR‐negative PBPC grafts had similar progression‐free survival (PFS) (P = 0·49). However, a significant difference was seen in PFS and overall survival (OS) for the patients given ≥6·1 × 106 CD34+ cells/kg compared with those given <6·1 × 106 CD34+ cells/kg (P = 0·01 and P < 0·05 respectively).