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Cryopreserved versus non-cryopreserved stem cell autografts in multiple myeloma a restrospective cohort study

Bone Marrow Transplantation volume 57, pages 1313–1318 (2022)Cite this article

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Abstract

The use of non-cryopreserved hematopoietic stem cells (HSC) can be an alternative to the traditional cryopreserved infusions of HSCs in autologous stem cell transplantation (aHSCT). After high-dose melphalan conditioning (HDM), we sought to compare time to engraftment, overall survival, and safety in multiple myeloma (MM) patients undergoing a first aHSCT after high-dose melphalan conditioning (HDM). We conducted a cohort study from March 2018 to December 2019. Of all autologous transplants performed during this period, 105 were for MM as the first consolidation. Fifty-one patients received a cryopreserved graft; the remaining 54 patients received a fresh infusion. General clinical characteristics were similar between these two groups. Cell viability was higher in non-cryopreserved grafts (95% vs. 86% p < 0.01). Four deaths occurred during hospitalization in the cryopreserved group, one in the non-cryopreserved group. The cumulative incidence of neutrophil and platelet engraftment on D + 25 was higher in the non-cryopreserved compared to the cryopreserved group (98% vs 90% p < 0.01 and 96.2% vs 72.54% p < 0.01 respectively). Additionally, the hospital length of stay was reduced by 4 days for patients for the non-cryopreserved cohort. In summary, the use of non-cryopreserved HSCs after HDM is safe and effective compared to patients who received a cryopreserved graft.

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Fig. 1: Flow diagram of patient inclusion.
Fig. 2: Cumulative incidente of neutrophil and platelet engraftment, with death in aplasia as competing risk.
Fig. 3: Kaplan–Meier overall survival of cryopreserved and fresh infusion cohort.

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Our dataset is available and will be provided under requested supported by adequate justification.

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Authors and Affiliations

  1. Division of Hematology, Hospital A Beneficência Portuguesa de São Paulo, São Paulo, Brazil

    Juliana Matos Pessoa, Eurides Leite da Rosa, André Dias Américo, Camila Lucena Motta, Rosana Rocha Concilio, Jose Ulysses Amigo Filho, Breno Moreno De Gusmão, Phillip Scheinberg & Fábio Rodrigues Kerbauy

  2. Research and Education Division, Hospital A Beneficência Portuguesa de São Paulo, São Paulo, Brazil

    Cleyton Zanardo de Oliveira

  3. Blood Bank and Apheresis Division, Hospital Beneficiência Portuguesa, São Paulo, Brazil

    Ana Cynira Franco Marret & Arlette Edna Lazar

  4. Federal University of São Paulo (UNIFESP), Hematology Department, São Paulo, Brazil

    Fábio Rodrigues Kerbauy

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Contributions

JMP was responsible for direct patient care and also data extraction and data analysis, interpreting the final results and writing the manuscript. ELR was also reponsible for direct patient care, interpreting the final results and manuscript review. ADA conducted data analysis, interpreted final results, wrote the manuscript, updated the reference list and created ‘summary of finding’ tables, writing the manuscript and manuscript review. CM, was responsible for designing the protocol and protocol supervision. CZO provided feedback on data extraction, data analysis, review of the statistical analysis and review of the manuscript. RRC conducted data extraction and submitted the research protocol for board ethic’s review. ACFM and AEL designed the protocol and conducted the apheresis procedures and stem cell harvest. JUAF, BMG, FRK and PS designed the protocol, were responsible for patient care, protocol supervision, interpreted the final results, helped writing the manuscript and reviewed the manuscript.

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Correspondence to Juliana Matos Pessoa.

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Pessoa, J.M., da Rosa, E.L., Américo, A.D. et al. Cryopreserved versus non-cryopreserved stem cell autografts in multiple myeloma a restrospective cohort study. Bone Marrow Transplant 57, 1313–1318 (2022). https://doi.org/10.1038/s41409-022-01718-2

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