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Fresh vs. frozen allogeneic peripheral blood stem cell grafts: A successful timely option

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Fresh vs. frozen allogeneic peripheral blood stem cell grafts: A successful timely option

American Journal of Hematology

Fecha de publicación: 27 de octubre de 2020

DOI: https://doi.org/10.1002/ajh.26033

Autores: Ahmad S. Alotaibi, Shruti Prem, Shiyi Chen, Jeffrey H. Lipton, Dennis D. Kim, Auro Viswabandya, Rajat Kumar, Wilson Lam, Arjun D. Law, Jonas Mattsson, Fotios V. Michelis

Abstract

Cryopreservation of grafts has been established in autologous and cord blood transplantation, yet there is little experience regarding the effect of cryopreservation with sibling and unrelated grafts. We evaluated the effect of cryopreservation of grafts on allogeneic transplant outcomes using related, unrelated and haploidentical donors, including 958 patients, age 18‐74 years (median 55) and using PBSC for various hematologic malignancies. Fresh grafts were received by 648 (68%) patients, 310 (32%) received cryopreserved. There was no difference between fresh vs cryopreserved grafts for neutrophil engraftment (P = .09), platelet engraftment (P = .11), graft failure (5.6% vs 6.8%, P = .46) and grade II‐IV acute graft‐vs‐host disease (GVHD) (P = .71), moderate/severe chronic GVHD was observed in 176 (27%) vs 123 (40%) patients, respectively (P < .001). Multivariable analysis demonstrated no difference between fresh vs cryopreserved for OS (P = .39) and CIR (P = .08) while fresh grafts demonstrated borderline increased NRM (HR 1.27, 95% CI 1.02‐1.59, P = .04). Of note, for patients with no or mild chronic GVHD, CIR was less for fresh compared to cryopreserved (HR = 0.67 for fresh, 95% CI 0.48‐0.92, P = .01). We conclude there were no differences in engraftment and survival between fresh and cryopreserved grafts for allogeneic HCT, thus establishing cryopreservation to be a safe option for allogeneic HCT.

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