Content of Endothelial Progenitor Cells in Autologous Stem Cell Grafts Predict Survival after Transplantation for Multiple Myeloma

• Published in: Biology of blood and marrow transplantation Vol. 21; no. 5; pp. 840 - 847
• Main Authors: Blix, Egil S, Kildal, Anders B, Bertelsen, Eirin, Waage, Anders, Myklebust, June H, Kolstad, Arne, Husebekk, Anne
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2015
• Subjects: AC133 Antigen; Adult; Aged; Aldehyde dehydrogenase; Angiogenesis; Antigens, CD - metabolism; Antigens, CD34 - metabolism; Autografts; Autologous stem cell transplantation; CD133; Disease-Free Survival; Endothelial Cells - metabolism; Endothelial progenitor cells; Follow-Up Studies; Glycoproteins - metabolism; Hematology, Oncology and Palliative Medicine; Humans; Middle Aged; Multiple myeloma; Multiple Myeloma - metabolism; Multiple Myeloma - mortality; Multiple Myeloma - pathology; Multiple Myeloma - therapy; Neovascularization, Pathologic - metabolism; Neovascularization, Pathologic - mortality; Neovascularization, Pathologic - pathology; Neovascularization, Pathologic - therapy; Peptides - metabolism; Predictive Value of Tests; Stem Cell Transplantation; Survival Rate; Vascular Endothelial Growth Factor Receptor-2 - metabolism; Angiogenesis; Aldehyde dehydrogenase; Autologous stem cell transplantation; Multiple myeloma; Endothelial progenitor cells; CD133
• ISSN: 1083-8791; 1523-6536
• DOI: 10.1016/j.bbmt.2014.12.027

Abstract Multiple myeloma (MM) is considered an incurable B cell malignancy, although many patients can benefit from high-dose therapy with autologous stem cell transplantation (ASCT) as a first-line treatment. In non-Hodgkin lymphoma (NHL), ASCT is usually performed after relapse with curative intent. Disease progression is often associated with increased angiogenesis, in which endothelial progenitor cells (EPC) may have a central role. Here, we investigated the clinical impact of EPC levels in peripheral blood stem cell (PBSC) autografts for MM and NHL patients who received ASCT. EPC were identified by flow cytometry as aldehyde dehydrogenasehi CD34+ vascular endothelial growth factor receptor 2+ CD133+ cells in both MM and NHL autografts. In MM, there was a positive correlation between EPC percentage and serum (s)-β2 -microglobulin levels ( r 2  = .371, P  = .002). Unlike for NHL patients, MM patients with high numbers of infused EPC (EPC cells per kilogram) during ASCT had significant shorter progression-free survival (PFS) ( P  = .035), overall survival ( P  = .044) and time to next treatment ( P  = .009). In multivariate analysis, EPC cells per kilogram was a significant independent negative prognostic indicator of PFS ( P  = .03). In conclusion, the presence of high number of EPC in PBSC grafts is associated with adverse prognosis after ASCT in MM.