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. 2023 Mar;117(3):428-437.
doi: 10.1007/s12185-022-03493-8. Epub 2022 Nov 15.

Cryopreserved versus fresh peripheral blood allogeneic stem cell transplantation outcomes in patients receiving post-transplant cyclophosphamide for graft-versus-host prophylaxis during the COVID-19 pandemic: a single center experience

Mengni Guo  1 , Jieying Liu  1 , Pamela Clark  2 , Sarfraz Ahmad  3 , Rushang Patel  2 , Juan Carlos Varela  2 , Shahram Mori  4
Affiliations

Cryopreserved versus fresh peripheral blood allogeneic stem cell transplantation outcomes in patients receiving post-transplant cyclophosphamide for graft-versus-host prophylaxis during the COVID-19 pandemic: a single center experience

Mengni Guo et al. Int J Hematol. 2023 Mar.

Abstract

Background/objective: Cryopreservation of grafts is not common practice in allogeneic hematopoietic stem cell transplant (HSCT) recipients. However, our center had to use cryopreserved cells for allogeneic HSCT during the COVID-19 pandemic to avoid delays in transplantation due to uncertainty regarding patient and donor exposures.

Study design: We retrospectively evaluated post-transplant engraftment and survival outcomes of adult patients who received cryopreserved versus fresh allografts during the COVID-19 pandemic.

Results: Fifty-five patients with hematologic malignancies received either cryopreserved (n = 34) or fresh (n = 21) allogeneic HSCT using peripheral blood stem cells between January 2020 and December 2020. At a median follow-up time of 15 months, cryopreserved allograft recipients had significantly lower overall survival (OS) (p = 0.02). They also experienced significantly delayed neutrophil (p = 0.01) and platelet engraftments (p < 0.0001), as well as higher red blood cell transfusion-dependence after day + 60 (67.6% vs. 28.6%; p = 0.01). Significantly more cryopreserved allograft recipients received donor lymphocyte infusion than fresh allograft recipients (35.3% vs. 4.8%, p = 0.01). Neither relapse-free survival nor non-relapse mortality differed significantly between the two groups.

Conclusion: Cryopreservation of allografts in combination with post-transplant cyclophosphamide may negatively affect engraftment and OS outcomes in HSCT recipients.

Keywords: Allogeneic; COVID-19; Cryopreservation; Engraftment; Transplantation.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a Cumulative incidence of neutrophil engraftment; b Cumulative incidence of platelet engraftment
Fig. 2
Fig. 2
Non-relapse mortality (NRM)
Fig. 3
Fig. 3
a Overall survival; b Relapse-free survival
See this image and copyright information in PMC

References

    1. Wiercinska E, Schlipfenbacher V, Bug G, Bader P, Verbeek M, Seifried E, et al. Allogeneic transplant procurement in the times of COVID-19: quality report from the central European cryopreservation site. J Transl Med. 2021;19:145. doi: 10.1186/s12967-021-02810-9. - DOI - PMC - PubMed
    1. Alotaibi AS, Prem S, Chen S, Lipton JH, Kim DD, Viswabandya A, et al. Fresh vs. frozen allogeneic peripheral blood stem cell grafts: A successful timely option. Am J Hematol. 2021;96:179–87. doi: 10.1002/ajh.26033. - DOI - PubMed
    1. Kim DH, Jamal N, Saragosa R, Loach D, Wright J, Gupta V, et al. Similar outcomes of cryopreserved allogeneic peripheral stem cell transplants (PBSCT) compared to fresh allografts. Biol Blood Marrow Transplant. 2007;13:1233–1243. doi: 10.1016/j.bbmt.2007.07.003. - DOI - PubMed
    1. Devine SM. Transplantation of allogeneic cryopreserved hematopoietic cell grafts during the COVID-19 pandemic: a National Marrow Donor Program perspective. Am J Hematol. 2021;96:169–171. doi: 10.1002/ajh.26052. - DOI - PMC - PubMed
    1. Hsu JW, Farhadfar N, Murthy H, Logan BR, Bo-Subait S, Frey N, et al. The effect of donor graft cryopreservation on allogeneic hematopoietic cell transplantation outcomes: a center for international blood and marrow transplant research analysis. Implications during the COVID-19 pandemic. Transplant Cell Ther. 2021;27:507–16. doi: 10.1016/j.jtct.2021.03.015. - DOI - PMC - PubMed

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