Immune profiling in Diffuse Large B-Cell Lymphoma and Mantle Cell Lymphoma Patients treated with Autologous Hematopoietic Cell Transplant

This is the first longitudinal study of immune profiles and autologous hematopoietic cell transplant (AHCT) survival in B-cell non-Hodgkin lymphoma (B-NHL) patients and the effect of plerixafor mobilization on immune reconstitution in this population. A comprehensive immunophenotyping panel was performed in 104 consecutive adult B-NHL patients (58% diffuse large B-cell, 42% mantle cell) who received AHCT (1/2008-11/2014), at a median of 28 days pre-AHCT (N=104) and Day+100 (N=83) post-AHCT. Median follow-up post-AHCT was 61 months (range: 8-120 months). Compared to patients mobilized with filgrastim and plerixafor, patients mobilized with filgrastim alone had a higher proportion of CD4+ naïve (p=0.006) and CD8+ central memory T-cells (p=0.006) pre-AHCT. For patients transplanted in complete remission (CR), a higher proportion of CD8+ effector memory T-cells pre-AHCT was associated with worse progression-free survival (PFS; p<0.01) and overall survival (OS; p<0.01). A higher ratio of CD8:CD4+ central memory T-cells pre-AHCT was associated with worse PFS (p<0.0001) and OS (p=0.0034). This same ratio measured post-AHCT among patients in CR on Day+100 was associated with worse and OS (p=0.008) but not PFS (p=not significant). These immune subsets are complementary biomarkers which identify patients transplanted in CR who have poor survival prognoses and may warrant further clinical interventions.