Efficacy of ex vivo Purging with CD34+ Selection to Maximize the Effects of Autologous Stem Cell Transplantation in Peripheral T-cell Lymphoma Patients

Peripheral T-cell lymphomas (PTCLs) are rare and aggressive tumors with uncertain optimal treatment. This study investigated the clinical outcomes of high-dose chemotherapy followed by autologous stem cell transplantation (HDT/ASCT) after CD34+ selective purging in PTCL patients. Retrospective analysis included 67 PTCL patients who achieved remission and underwent HDT/ASCT. CD34+ selective purging was performed using CliniMACS. Survival outcomes, engraftment, lymphocyte subsets, and viral infections were evaluated. CD34+ selective purged autografts were associated with significantly improved overall survival (OS) and disease-free survival (DFS) compared to unpurged autografts (5-year OS: 73.3% vs. 37.8%; 5-year DFS: 73.8% vs. 33.4%). The cumulative incidence of relapse was also lower in the purged group (31.5% vs. 73.3%). Subgroup analysis revealed significant survival benefits in the high-risk group receiving purged autografts. Lymphocyte subset analysis showed increased natural killer (NK) cell counts in the purged group after ASCT. Higher post-ASCT lymphocyte-to-monocyte ratio (LMR) was associated with improved OS and DFS. CD34+ selective purging in PTCL patients undergoing HDT/ASCT improved survival outcomes and reduced relapse risk. The procedure increased NK cell counts and post-ASCT LMR. CD34+ selective purging may minimize autograft tumor cell contamination and enhance efficacy in T-cell lymphomas. [Display omitted]