Day 100 Natural Killer Cell/CD14+HLA-DR^DIM ratio and survival in lymphoma post-autologous peripheral blood hematopoietic stem cell transplantation

Introduction: The infusion of autograft Natural Killer Cells (NKC)/CD14⁺HLA-DR^DIM ratio is a predictor of survival in lymphoma patients undergoing autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT). This study evaluated if the Day 100 NKC/CD14⁺HLA-DR^DIM ratio still functions as a prognostic immune-biomarker. Methods: This was a retrospective, single-institution, cohort analysis including 107 patients in this study that had clinical assessment at Day 100 post-APBHSCT from our prior phase III trial. We evaluated the prognostic ability of the Day 100 NKC/CD14⁺HLA-DR^DIM ratio to predict overall survival (OS) and progression-free survival (PFS) using Cox regression model for outcome analysis and survival by Kaplan–Meier method. Results: The median follow-up from day 100 was 94.7 months (range 4.83–158.1 months) for the entire cohort. Patients with a Day 100 NKC/CD14⁺HLA-DR^DIM ratio ≥1.67 experienced better OS and PFS versus those with a Day 100 NKC/CD14⁺HLA-DR^DIM ratio <1.67: median OS was not reached versus 49.7 months, the 5-year OS rates were 91% (95% CI, 81%–96%) versus 40% (95% CI, 27%–55%), p <.0001, respectively; and median PFS was not reached versus 23.5 months, the 5-year PFS rates were 66% (95% CI, 55%–81%) versus 21% (95% CI, 15%–40%), p <.0001, respectively. Day 100 NKC/CD14⁺HLA-DR^DIM ratio was an independent predictor for OS and PFS in the multivariate analysis. Conclusions: Day 100 NKC/CD14⁺HLA-DR^DIM ratio is a prognostic immune-biomarker in lymphoma patients post- APBHSCT.