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Lymphoma

Ex vivo B cell depletion using the Eligix B Cell SC system and autologous peripheral blood stem cell transplantation in patients with follicular non-Hodgkin's lymphoma

Summary:

One limitation of ASCT is the potential reinfusion of tumor cells contaminating PBSC. The Eligix B cell SC system consists of high-density microparticles coated with anti-B cell antibodies. To determine if this system eliminates B cells and lymphoma cells from PBSC, immunocytochemistry and PCR of the bcl-2/IgH rearrangement were performed, and correlated with patient outcome after ASCT. Eligible patients (n=29) had relapsed or transformed follicular NHL with bone marrow involvement <20%, and all lymph nodes <5 cm. PBSCs were mobilized with cyclophosphamide/G-CSF (n=21), and patients were conditioned with cyclophosphamide, carmustine and etoposide.Using immunocytochemistry on PBSC, the median number of CD20+ cells pre-purge was 310/106 (range 0–16692) and post-purge was 0.75/106; the median log B cell depletion was 2.7 (range 1.4–3.9). B cell depletion correlated with PFS after ASCT (P=0.06). Of 17 available samples for PCR, only four had a detectable t(14;18) breakpoint. After purging, all four remained PCR+; two had a 1–3 log depletion of lymphoma cells. At median follow-up of 18 months, 10 patients, including five infused with PCR-negative PBSC, have had disease progression. The paucity of PCR-informative patients, possibly related to in vivo rituximab therapy, limited the utility of minimal residual disease as a surrogate marker of clinical outcome.

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Acknowledgements

We thank the staff of the Dana-Farber Cancer Institute Blood Donor Center and the Connell and O'Reilly Families Cell Manipulation Core Facility for the collection and processing of peripheral blood stem cells. We are also indebted to the nurses, adult oncology fellows and social workers of the Dana-Farber Cancer Institute and Massachusetts General Hospital, and the housestaff and nursing staff of the Brigham and Women's Hospital and Massachusetts General Hospital for their excellent care of these patients. Supported by NIH Grant CA 66996. Dr Friedberg has a clinical research career development award from the Lymphoma Research Foundation.

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Correspondence to J W Friedberg.

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Presented in part at the 44th Annual Meeting of the American Society of Hematology, Philadelphia, PA; December 2002.

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Friedberg, J., Kim, H., Li, S. et al. Ex vivo B cell depletion using the Eligix B Cell SC system and autologous peripheral blood stem cell transplantation in patients with follicular non-Hodgkin's lymphoma. Bone Marrow Transplant 32, 681–686 (2003). https://doi.org/10.1038/sj.bmt.1704212

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