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Wan BA, Lindo L, Mourad YA, Chung S, Forrest D, Kuchenbauer F, Nantel S, Narayanan S, Nevill T, Power M, Rodrigo J, Sanford D, Song K, Stubbins RJ, Sutherland H, Toze CL, White J, Roy C, Hay KA. Outcomes with allogeneic stem cell transplant using cryopreserved versus fresh hematopoietic progenitor cell products. Cytotherapy 2024:S1465-3249(24)00711-4. [PMID: 38819367 DOI: 10.1016/j.jcyt.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/05/2024] [Accepted: 05/05/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplant (alloHSCT) is a mainstay of treatment for hematologic malignancies such as acute leukemias and aggressive lymphomas. Historically, fresh hematopoietic progenitor cell (HPC) products have been preferred to cryopreserved products (cryo-HPC) due to concerns of loss of stem cell viability and number with the cryopreservation procedure. OBJECTIVE We aimed to analyze the outcomes of patients who received cryo-HPCs during the COVID-19 pandemic and compare this against historical cohorts that received fresh HPC. STUDY DESIGN A retrospective chart review was conducted on all adult patients who received a peripheral blood alloHSCT in British Columbia, Canada between June 2017 and November 2021. Baseline characteristics, Kaplan-Meier (KM) overall survival (OS), engraftment, and incidences of acute and chronic graft versus host disease were compared between patients who received cryo-HPCs and fresh HPCs. Univariable analysis followed by multivariable analysis was performed using a backward stepwise selection procedure to generate predictors of OS, cumulative incidence of relapse (CIR), nonrelapse mortality (NRM), and primary and secondary graft failure. RESULTS Three hundred eighty-three patients were included in the analysis, with cryo-HPC representing 40%. Median viability was higher in the fresh-HPC group at 99.2% (IQR 98.3-99.5) versus cryo-HPCs at 97.0% (96.0, 98.6) (P < 0.01). The 12-month actuarial survivals were 77% in the fresh HPC and 75% in the cryo-HPC groups (P = 0.21). There were no differences between cryo-HPCs and fresh HPCs on univariable analysis of OS, CIR, or NRM. There was a shorter median time to platelet engraftment in patients receiving fresh HPC at 17 days (IQR 16, 20) versus cryo-HPC at 21 days (IQR 18, 29), P < 0.001. There was a shorter median time to neutrophil engraftment in the fresh HPC group at 17 days (IQR 14, 20) versus 20 days (17, 23), P < 0.001. Cryo-HPC accounted for 5 out of 6 cases of primary graft failure (P = 0.04), and 3 out of five cases of secondary graft failure (P = 0.39). There were no significant differences in acute GVHD between the fresh HPC and cryo-HPC groups (P = 0.34). The incidence of moderate or severe chronic GVHD was 32% in the fresh-HPC group and 17% in the cryo-HPC group (P < 0.001). In multivariable analysis, cryopreservation did not emerge as an independent predictor of OS, CIR, NRM, primary GF or secondary GF. However, viability <90% on arrival at our center was a significant predictor of OS (HR 5.3, 2.3-12.3, P < 0.01), primary graft failure (OR 36.3, 5.4-210.2, P < 0.01), and secondary graft failure (OR 18.4, 1.7-121.1, P < 0.01). CONCLUSIONS Patients who received cryo-HPCs had similar OS and relapse rates to those who received fresh-HPCs but typically took 2-3 days longer to achieve engraftment of platelets or neutrophils and were associated increased primary graft failure. However, after accounting for multiple variables, cryopreservation was no longer a significant predictor of survival or engraftment while viability <90% emerged as an important predictor of OS, primary graft failure, and secondary graft failure. If confirmed, this suggests that viability on arrival at the infusion center may be a good quality control indicator used to identify HPC products that may warrant recollection if the risk of graft failure is sufficiently increased.
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Affiliation(s)
- Bo Angela Wan
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lorenzo Lindo
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Terry Fox Laboratory, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Yasser Abou Mourad
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Shanee Chung
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Donna Forrest
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Florian Kuchenbauer
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Stephen Nantel
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Sujaatha Narayanan
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Tomas Nevill
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Maryse Power
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Judith Rodrigo
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - David Sanford
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Kevin Song
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Ryan J Stubbins
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Heather Sutherland
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Cynthia L Toze
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Jennifer White
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Claudie Roy
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada
| | - Kevin A Hay
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Terry Fox Laboratory, BC Cancer Research Institute, Vancouver, British Columbia, Canada; Leukemia/Bone Marrow Transplant Program of BC, Vancouver, British Columbia, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Strzelec A, Gawlik-Rzemieniewska N, Klima A, Panek K, Helbig G. The Impact of Cryopreservation on Hematopoietic Stem Cell Engraftment and Post-transplant Outcome During the COVID-19 Pandemic. In Vivo 2024; 38:1271-1277. [PMID: 38688614 PMCID: PMC11059856 DOI: 10.21873/invivo.13565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND/AIM The COVID-19 pandemic has had a significant impact on the current management of allotransplanted patients in whom fresh hematopoietic stem cells (HSCs) were replaced by cryopreserved ones. The aim of the study was to determine the efficacy and safety of cryopreserved HSCs when compared with the fresh ones. PATIENTS AND METHODS A retrospective analysis of 254 allogeneic stem cell transplantations (HSCT) procedures performed between 2020-2021 included the following donors: matched related (MRD; n=68), matched unrelated (MUD; n=148) and haploidentical (HID; n=38). 50% of patients (non-cryo group) received fresh grafts, whereas the remaining patients (cryo group) were transplanted with cryopreserved cells. RESULTS No differences in terms of median days to neutrophil [MRD/MUD/HID cryo- and non-cryo groups: 17 vs. 16 (p=0.27), 19 vs. 18 (p=0.83), 22 vs. 22 (p=0.83) days, respectively] and platelet [MRD/MUD/HID cryo- and non-cryo groups: 14 vs. 14 (p=0.25), 17 vs. 17 (p=0.33), 21 vs. 19 (p=0.36) days, respectively] engraftments were demonstrated. Among MUD graft recipients, platelet engraftment rates were 81% in the cryo- and 96% in the non-cryo group (p=0.01). OS rates were comparable at 1 year after HSCT between MRD/MUD/HID cryo- and non-cryo groups: 53% vs. 60% (p=0.54), 60% vs. 66% (p=0.5), 50% vs. 41% (p=0.56), respectively. CONCLUSION During the COVID-19 pandemic, cryopreserved HSCs did not have a negative impact on median engraftment time and OS when compared to fresh HSCs. In the MUD group, platelet engraftment rate was lower in cryopreserved HSC recipients.
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Affiliation(s)
- Anna Strzelec
- Faculty of Medicine in Katowice, Medical University of Silesia, Department of Hematology and Bone Marrow Transplantation, Katowice, Poland
| | - Natalia Gawlik-Rzemieniewska
- Faculty of Medicine in Katowice, Medical University of Silesia, Department of Hematology and Bone Marrow Transplantation, Katowice, Poland
| | - Anna Klima
- Faculty of Medicine in Katowice, Medical University of Silesia, Department of Hematology and Bone Marrow Transplantation, Katowice, Poland
| | - Karolina Panek
- Faculty of Medicine in Katowice, Medical University of Silesia, Department of Hematology and Bone Marrow Transplantation, Katowice, Poland
| | - Grzegorz Helbig
- Faculty of Medicine in Katowice, Medical University of Silesia, Department of Hematology and Bone Marrow Transplantation, Katowice, Poland
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Valentini CG, Pellegrino C, Teofili L. Pros and Cons of Cryopreserving Allogeneic Stem Cell Products. Cells 2024; 13:552. [PMID: 38534396 DOI: 10.3390/cells13060552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/16/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
The COVID-19 pandemic has precipitously changed the practice of transplanting fresh allografts. The safety measures adopted during the pandemic prompted the near-universal graft cryopreservation. However, the influence of cryopreserving allogeneic grafts on long-term transplant outcomes has emerged only in the most recent literature. In this review, the basic principles of cell cryopreservation are revised and the effects of cryopreservation on the different graft components are carefully reexamined. Finally, a literature revision on studies comparing transplant outcomes in patients receiving cryopreserved and fresh grafts is illustrated.
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Affiliation(s)
- Caterina Giovanna Valentini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, 00168 Rome, Italy
| | - Claudio Pellegrino
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, 00168 Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luciana Teofili
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, 00168 Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Devine SM, Bo-Subait S, Kuxhausen M, Spellman SR, Bupp C, Ahn KW, Stefanski HE, Auletta JJ, Logan BR, Shaw BE. Clinical impact of cryopreservation of allogeneic hematopoietic cell grafts during the onset of the COVID-19 pandemic. Blood Adv 2023; 7:5982-5993. [PMID: 37036959 PMCID: PMC10580174 DOI: 10.1182/bloodadvances.2023009786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/12/2023] Open
Abstract
At the onset of the COVID-19 pandemic, the National Marrow Donor Program mandated the cryopreservation of hematopoietic cell grafts from volunteer unrelated donors because of numerous patient and donor safety concerns and logistical hurdles. Using the Center for International Blood and Marrow Transplant Research outcomes database, we report the impact of cryopreservation on overall survival (OS) and other outcomes within 1 year after hematopoietic cell transplantation (HCT). We analyzed 1543 recipients of cryopreserved allografts receiving HCT at US centers during the first 6 months of the pandemic and compared them with 2499 recipients of fresh allografts during a 6-month period in 2019. On multivariable regression analysis, we observed no difference in the OS (P = .09), nonrelapse mortality (P = .89), graft-versus-host disease (GVHD), or GVHD- and relapse-free survival (P = .58) in recipients of cryopreserved vs fresh allografts. Disease-free survival (DFS) was lower in the cryopreserved allograft recipients (P = .006) because of a higher risk of relapse (P = .01) compared with the fresh allograft recipients. Primary graft failure was higher (P = .01), and the risk of chronic GVHD was lower (P = .001) with cryopreservation compared with fresh grafts. In conclusion, although there was no negative impact of cryopreservation on OS, relapse was higher, and DFS was lower than that with no cryopreservation. Fresh grafts are recommended as the pandemic-related logistical hurdles resolve. Cryopreservation should be considered an option for patients when fresh grafts are not feasible.
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Affiliation(s)
- Steven M. Devine
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Stephanie Bo-Subait
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Michelle Kuxhausen
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Stephen R. Spellman
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Caitrin Bupp
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Kwang Woo Ahn
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Heather E. Stefanski
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Jeffery J. Auletta
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Brent R. Logan
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Bronwen E. Shaw
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
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5
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Keyzner A, Azzi J, Jakubowski R, Sinitsyn Y, Tindle S, Shpontak S, Kwon D, Isola L, Iancu-Rubin C. Cryopreservation of Allogeneic Hematopoietic Cell Products During COVID-19 Pandemic: Graft Characterization and Engraftment Outcomes. Transplant Proc 2023; 55:1799-1809. [PMID: 37210273 PMCID: PMC10121136 DOI: 10.1016/j.transproceed.2023.03.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 02/22/2023] [Accepted: 03/30/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND The COVID-19 pandemic triggered the deployment of unfamiliar measures to safeguard successful allogeneic hematopoietic cell transplantation (allo-HCT). Among these measures, cryopreservation offered logistical benefits that could outlast the pandemic, including graft availability and timely clinical service. The purpose of this study was to evaluate graft quality and hematopoietic reconstitution in patients transplanted with cryopreserved allogeneic stem cell products during the COVID-19 pandemic. METHODS We evaluated 44 patients who underwent allo-HCT using cryopreserved grafts consisting of hematopoietic progenitor cells (HPC) apheresis (A) and bone marrow (BM) products at Mount Sinai Hospital. Comparative analyses of 37 grafts infused fresh during the one-year period preceding the pandemic were performed. Assessment of cellular therapy products included total nucleated cell and CD34+ cell enumeration, viability, and post-thaw recovery. The primary clinical endpoint was the evaluation of engraftment (absolute neutrophil count [ANC] and platelet count) and donor chimerism (presence of CD33+ and CD3+ donor cells) at day +30 and +100 post-transplant. Adverse events related to cell infusion were also analyzed. RESULTS Patient characteristics were comparable between the fresh and cryopreserved groups with 2 exceptions in the HPC-A cohort: the number of patients in the cryopreserved group that received haploidentical grafts was 6 times that in the fresh group, and the number of patients in the fresh group with a Karnofsky performance score >90 was double that in the cryopreserved group. The quality of HPC-A and HPC-BM products was not affected by cryopreservation, and all grafts met the release criteria for infusion. The pandemic did not affect the time between collection and cryopreservation (median, 24 hours) and time in storage (median, 15 days). Median time to ANC recovery was significantly delayed in recipients of cryopreserved HPC-A (15 vs 11 days, P = .0121), and there was a trend toward delayed platelet engraftment (24 vs 19 days, P = .0712). The delay in ANC and platelet recovery was not observed when only matched graft recipients were compared. Cryopreservation did not affect the ability of HPC-BM grafts to engraft and reconstitute hematopoiesis, and there was no difference in the rates of ANC and platelet recovery. Achievement of donor CD3/CD33 chimerism was not affected by cryopreservation of either HPC-A or HPC-BM products. Graft failure was observed in only 1 case, a recipient of cryopreserved HPC-BM. Three recipients of cryopreserved HPC-A grafts died before ANC engraftment from infectious complications. Remarkably, 22% of our studied population had myelofibrosis, and almost half received cryopreserved HPC-A grafts with no graft failure observed. Finally, patients receiving cryopreserved grafts were at a higher risk of infusion-related adverse events than those receiving fresh grafts. CONCLUSIONS Cryopreservation of allogeneic grafts results in adequate product quality with minimal impact on short-term clinical outcomes, except for an increased risk of infusion-related adverse events. Cryopreservation is a safe option in terms of graft quality and hematopoietic reconstitution with logistical benefits, but additional data are needed to determine long-term outcomes and assess whether this is a suitable strategy for at-risk patients.
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Affiliation(s)
- Alla Keyzner
- Stem Cell Transplantation and Cellular Therapy Program, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jacques Azzi
- Stem Cell Transplantation and Cellular Therapy Program, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | | | | | - Deukwoo Kwon
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Luis Isola
- Stem Cell Transplantation and Cellular Therapy Program, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Camelia Iancu-Rubin
- Stem Cell Transplantation and Cellular Therapy Program, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
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6
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Rimac V, Bojanić I, Dabelić S, Ćepulić BG. Variable recovery of cryopreserved hematopoietic stem cells and leukocyte subpopulations in leukapheresis products. Transfus Apher Sci 2023; 62:103763. [PMID: 37460360 DOI: 10.1016/j.transci.2023.103763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 11/27/2023]
Abstract
INTRODUCTION Due to the expansion of cell therapy using not only haematopoietic stem cells (HSC) but also other leukocyte subpopulations, the loss of these cells in cryopreserved apheresis products needs to be evaluated. Various factors that could negatively affect post-thaw recovery, such as leukapheresis product characteristics, storage time and cryopreservation protocols have been identified. METHODS The post-thaw recovery of HSCs, lymphocytes, NK cells and monocytes, as well as the factors that could adversely affect it were analysed in autologous and allogeneic leukapheresis products. RESULTS The lowest post-thaw recovery was observed in autologous and allogeneic CD34+ cells, with the median of 73.7% and 68.1%, respectively. In leukocyte subpopulation, the lowest post-thaw recovery was observed for CD14+ cells, both autologous and allogeneic. The highest post-thaw recovery was observed for CD3+/CD8+ cells in autologous, and for CD19+ cells in allogeneic samples. The statistically significant difference was observed between autologous and allogeneic PBSC products for CD3+ cell recovery (P = 0.031) and CD3+/CD8+ cell recovery (P = 0.009). The evaluation of factors that could adversely affect the post-thaw recovery in autologous samples showed weak negative correlations between platelet concentration and CD3+ recovery, as well as between storage time and CD3+CD8+ recovery. In allogeneic samples, a strong negative correlation was observed only between the percentage of granulocytes and CD3+, CD3+/CD8+ and CD3+/CD4+ cell recoveries. CONCLUSION Since various post-thaw recoveries of leukocyte subpopulations were observed, the cell therapy manufacturing centers should evaluate how their cryopreservation method and other factors affect the recovery of cell population of interest in their settings.
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Affiliation(s)
- Vladimira Rimac
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - Ines Bojanić
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Šalata 3, 10000 Zagreb, Croatia; University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10000 Zagreb, Croatia.
| | - Sanja Dabelić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, A. Kovačića 1, 10 000 Zagreb, Croatia
| | - Branka Golubić Ćepulić
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Šalata 3, 10000 Zagreb, Croatia; University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10000 Zagreb, Croatia
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7
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Okamoto S, Iida M, Hamad N, Duarte FB, Sureda A, Srivastava A, Galeano S, Chao N, Rondelli D, Flowers ME. American Society of Transplantation and Cellular Therapy International Affair Committee: Report of 3 rd Workshop on Global Perspective to Access to Transplantation at the 2022 Tandem Meeting. Transplant Cell Ther 2023:S2666-6367(23)01134-X. [PMID: 36921918 DOI: 10.1016/j.jtct.2023.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Affiliation(s)
- Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Minako Iida
- Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Nada Hamad
- Department of Hematology, St Vincent's Hospital Sydney, Australia; School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Australia; School of Medicine, Sydney, University of Notre Dame Australia
| | | | - Anna Sureda
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | - Alok Srivastava
- Department of Haematology, Christian Medical College, Kilminnal, Ranipet, Tamil Nadu, India
| | | | - Nelson Chao
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC, USA
| | - Damiano Rondelli
- Division of Hematology and Oncology; Blood & Marrow Transplant Section in the Department of Medicine at the University of Illinois College of Medicine, Chicago, IL, USA
| | - Mary E Flowers
- Clinical Research Division, Fred Hutchinson Cancer Center and the Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
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8
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Koo J, Auletta JJ, Hartley DM, Huber J, Jaglowski S, Kapadia M, Kusnier K, Lehmann L, Maakaron J, Myers KC, Pai A, Parker L, Phelan R, Sper C, Rotz SJ, Dandoy CE. Secondary Impact of the Coronavirus Disease 19 Pandemic on Patients and the Cellular Therapy Healthcare Ecosystem. Transplant Cell Ther 2022; 28:737-746. [PMID: 35902050 PMCID: PMC9313529 DOI: 10.1016/j.jtct.2022.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has significantly impacted global health and healthcare delivery systems. To characterize the secondary effects of the COVID-19 pandemic and mitigation strategies used in the delivery of hematopoietic stem cell transplantation (HSCT) care, we performed a comprehensive literature search encompassing changes in specific donor collection, processing practices, patient outcomes, and patient-related concerns specific to HSCT and HSCT-related healthcare delivery. In this review, we summarize the available literature on the secondary impacts the COVID-19 pandemic on the fields of HSCT and cellular therapy. The COVID-19 pandemic has had numerous secondary impacts on patients undergoing HSCT and the healthcare delivery systems involved in providing complex care to HSCT recipients. Institutions must identify these influences on outcomes and adjust accordingly to maintain and improve outcomes for the transplantation and cellular therapy community.
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Affiliation(s)
- Jane Koo
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio.
| | - Jeffrey J Auletta
- Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin; Hematology/Oncology/BMT and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - David M Hartley
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - John Huber
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Samantha Jaglowski
- Division of Hematology-Oncology and Transplantation; Department of Pediatrics, Ohio State University Medical Center, Columbus, Ohio
| | - Malika Kapadia
- Division of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard University Medical School, Boston, Massachusetts
| | - Katilyn Kusnier
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Leslie Lehmann
- Division of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard University Medical School, Boston, Massachusetts
| | - Joseph Maakaron
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Kasiani C Myers
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Ahna Pai
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio; Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Loretta Parker
- Division of Hematology/Oncology, Department of Pediatrics, The University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Rachel Phelan
- Division of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Department of Pediatrics, Medical College of Wisconsin and Children's Wisconsin, Milwaukee, Wisconsin
| | - Christine Sper
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Christopher E Dandoy
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
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9
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Wiercinska E, Bönig H. Zelltherapie in den Zeiten von SARS-CoV-2. TRANSFUSIONSMEDIZIN 2022. [DOI: 10.1055/a-1720-7975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
ZusammenfassungEin breites Spektrum von Disruptionen, aber auch blitzschnelle Innovationen, hat
die SARS-CoV-2 Pandemie gebracht. Dieser Übersichtsartikel betrachtet
die Pandemie aus der Warte der Zelltherapie; konkret werden vier Aspekte
untersucht: Wie unterscheiden sich die Risiken von Zelltherapie-Patienten mit
SARS-CoV-2 Infektion und COVID von denen der Allgemeinbevölkerung? Sind
Empfänger von Zelltherapien, hier speziell autologe und allogene
Stammzelltransplantationsempfänger sowie Empfänger von
CAR-T-Zell-Präparaten, klinisch relevant durch SARS-CoV-2 Vakzine
immunisierbar? Welche Auswirkungen hat die Pandemie mit Spenderausfallrisiko und
Zusammenbruch von Supply Chains auf die Versorgung mit Zelltherapeutika? Gibt es
Zelltherapeutika, die bei schwerem COVID therapeutisch nutzbringend eingesetzt
werden können? In aller Kürze, das erwartete massiv
erhöhte Risiko von Zelltherapie-Patienten, im Infektionsfall einen
schweren Verlauf zu erleiden oder zu sterben, wurde bestätigt. Die
Vakzine induziert jedoch bei vielen dieser Patienten humorale und
zelluläre Immunität, wenn auch weniger zuverlässig als
bei Gesunden. Dank kreativer Lösungen gelang es, die Versorgung mit
Zelltherapeutika im Wesentlichen uneingeschränkt aufrecht zu erhalten.
SARS-CoV-2-spezifische T-Zell-Präparate für den adoptiven
Immuntransfer wurden entwickelt, eine therapeutische Konstellation diese
anzuwenden ergab sich jedoch nicht. Therapiestudien mit mesenchymalen
Stromazellen beim schweren COVID laufen weltweit; die Frage der Wirksamkeit
bleibt zurzeit offen, bei jedoch substanziellem Optimismus in der Szene. Einige
der Erkenntnisse und Innovationen aus der SARS-CoV-2-Pandemie können
möglicherweise verallgemeinert werden und so auf die Zeit nach ihrem
Ende langfristig nachwirken.
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Affiliation(s)
- Eliza Wiercinska
- DRK-Blutspendedienst Baden-Württemberg-Hessen, Institut
Frankfurt, Frankfurt a.M
| | - Halvard Bönig
- DRK-Blutspendedienst Baden-Württemberg-Hessen, Institut
Frankfurt, Frankfurt a.M
- Goethe Universität, Institut für Transfusionsmedizin
und Immunhämatologie, Frankfurt a.M
- University of Washington, Seattle, WA
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10
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Othman J, Aarons D, Bajel A, Butler J, Doocey R, O'Brien T, Purtill D, Smith L, Wilcox L, Hamad N. Allogeneic haematopoietic cell transplant services in Australia and New Zealand in the first year of the COVID-19 pandemic: A report from Australia and New Zealand Transplant and Cellular Therapies. Intern Med J 2022; 53:323-329. [PMID: 35833788 PMCID: PMC9349380 DOI: 10.1111/imj.15886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/03/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The COVID-19 pandemic has caused major disruption to health systems, with allogeneic haematopoietic cell transplant (alloHCT) services a particularly vulnerable area. Ongoing provision of alloHCT has required dynamic responses at national and local levels. In Australia and New Zealand (ANZ), a high reliance on unrelated donors from overseas registries has posed an additional challenge. AIMS To describe the impact of COVID-19 on alloHCT services in ANZ in the first year of the pandemic. METHODS Data from the national alloHCT recipient and unrelated donor registries was extracted for a 2-year time frame. Comparisons were made between a pre-pandemic period of 1st March 2019 to 29th February 2020 and the corresponding dates during the pandemic, 1st March 2020 to 28th February 2021. RESULTS There was a 13% decrease in the number of allogeneic transplants, a reversal of steady increases in previous years, with the largest decrease in unrelated donor transplants. Local donors supplied a greater proportion of unrelated stem cell products. With a switch to universal cryopreservation, the time from request of a product to infusion increased by a median of 25.5 days for overseas products and 14 days for local products. There was a significant increase in the number of products collected but not used. CONCLUSIONS A strong public health response and coordinated transplant community activities allowed for safe provision of alloHCT in ANZ, however our data suggests that the timely delivery of allogeneic transplants was affected by the COVID-19 pandemic. Continued dedicated efforts are required to minimise further impacts. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jad Othman
- Department of Haematology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Donna Aarons
- Australasian Bone Marrow Transplant Recipient Registry, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Ashish Bajel
- Department of Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Australia
| | - Jason Butler
- Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD
| | - Richard Doocey
- Department of Haematology, Auckland City Hospital, Auckland
| | - Tracey O'Brien
- Blood & Marrow Transplant Program, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - Duncan Purtill
- Blood and Marrow Transplant Program, Fiona Stanley Hospital, Perth, Australia
| | - Lisa Smith
- Australian Bone Marrow Donor Registry, Sydney, New South Wales, Australia
| | - Leonie Wilcox
- Australasian Bone Marrow Transplant Recipient Registry, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital, Sydney, Australia.,St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Australia.,School of Medicine Sydney, University of Notre Dame Australia, Australia
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11
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Fernandez-Sojo J, Horton R, Cid J, Azqueta C, Garcia-Buendia A, Valdivia E, Martorell L, Rubio-Lopez N, Codinach M, Aran G, Marsal J, Mussetti A, Martino R, Diaz-de-Heredia C, Ferra C, Valcarcel D, Linares M, Ancochea A, García-Rey E, García-Muñoz N, Medina L, Carreras E, Villa J, Lozano M, Gibson D, Querol S. Leukocytapheresis variables and transit time for allogeneic cryopreserved hpc: better safe than sorry. Bone Marrow Transplant 2022; 57:1531-1538. [PMID: 35804055 PMCID: PMC9264299 DOI: 10.1038/s41409-022-01750-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022]
Abstract
Cryopreservation was recommended to ensure continuity in allogeneic hematopoietic progenitor cells (HPC) transplantation during the COVID-19 pandemic. Several groups have shown no impact on clinical outcomes for patients who underwent HPC transplantation with cryopreserved products during the first months of this pandemic. However, concerns about quality control attributes after cryopreservation have been raised. We investigated, in 155 allogeneic peripheral blood cryopreserved HPC, leukocytapheresis characteristics influencing viable CD34+ and CD3+ cells, and CFU-GM recoveries after thawing. Collection characteristics such as volume, nucleated cells (NC)/mL and hematocrit correlated with viable CD34+ and CD3+ cells recoveries after thawing in univariate analysis but only CD3+ cells remained statistically significant in multivariate analysis (r2 = 0.376; P = < 0.001). Additionally, transit time also showed correlation with viable CD34+ (r2 = 0.186), CD3+ (r2 = 0.376) and CFU-GM recoveries (r2 = 0.212) in multivariate analysis. Thus, diluting leukocytapheresis below 200 × 106 NC/mL, avoiding red cells contamination above 2%, cryopreserving below 250 × 106 NC/mL and minimizing transit time below 36 h, prevented poor viable CD34+ and CD3+ cells, and CFU-GM recoveries. In summary, optimizing leukocytapheresis practices and minimizing transportation time may better preserve the quality attributes of HPC when cryopreservation is indicated.
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Affiliation(s)
- Jesus Fernandez-Sojo
- Advanced & Cell Therapy Services, Banc de Sang i Teixits, Barcelona, Spain; Transfusion Medicine Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain.
| | - Roger Horton
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, UK
| | - Joan Cid
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis ICMHO, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Carmen Azqueta
- Advanced & Cell Therapy Services, Banc de Sang i Teixits, Barcelona, Spain; Transfusion Medicine Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Ana Garcia-Buendia
- Data manager and statisticians, cell therapy department, Banc de Sang I Teixits, Barcelona, Spain
| | - Elena Valdivia
- Advanced & Cell Therapy Services, Banc de Sang i Teixits, Barcelona, Spain; Transfusion Medicine Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Lluis Martorell
- Advanced & Cell Therapy Services, Banc de Sang i Teixits, Barcelona, Spain; Transfusion Medicine Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Nuria Rubio-Lopez
- Advanced & Cell Therapy Services, Banc de Sang i Teixits, Barcelona, Spain; Transfusion Medicine Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | | | - Gemma Aran
- Cell Laboratory, Banc de Sang i Teixits, Barcelona, Spain
| | - Julia Marsal
- Pediatric Hematology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Alberto Mussetti
- Adult Hematology Department, Institut Catala d'Oncologia-Hospitalet, Barcelona, Spain
| | - Rodrigo Martino
- Adult Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institute, Universitat Autònoma of Barcelona, Barcelona, Spain
| | - Cristina Diaz-de-Heredia
- Department of Pediatric Hematology and Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Barcelona, Spain
| | - Christelle Ferra
- Adult Hematology Department, Institut Català d'Oncologia-Badalona, Barcelona, Spain
| | - David Valcarcel
- Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mónica Linares
- Banc de Sang i Teixits, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Transfusion Medicine Group, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Agueda Ancochea
- Banc de Sang i Teixits, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Enric García-Rey
- Banc de Sang i Teixits, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Nadia García-Muñoz
- Banc de Sang i Teixits, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Medina
- Banc de Sang i Teixits, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Enric Carreras
- Spanish Bone Marrow Donor Registry, Josep Carreras Foundation and Leukemia Research Institute, Barcelona, Catalonia, Spain
| | - Juliana Villa
- Spanish Bone Marrow Donor Registry, Josep Carreras Foundation and Leukemia Research Institute, Barcelona, Catalonia, Spain
| | - Miquel Lozano
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis ICMHO, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Daniel Gibson
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, UK
| | - Sergio Querol
- Advanced & Cell Therapy Services, Banc de Sang i Teixits, Barcelona, Spain; Transfusion Medicine Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain
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12
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Kanda Y, Doki N, Kojima M, Kako S, Inoue M, Uchida N, Onishi Y, Kamata R, Kotaki M, Kobayashi R, Tanaka J, Fukuda T, Fujii N, Miyamura K, Mori SI, Mori Y, Morishima Y, Yabe H, Atsuta Y, Kodera Y. Effect of Cryopreservation in Unrelated Bone Marrow and Peripheral Blood Stem Cell Transplantation in the Era of the COVID-19 Pandemic: An Update from the Japan Marrow Donor Program. Transplant Cell Ther 2022; 28:677.e1-677.e6. [PMID: 35803526 PMCID: PMC9259068 DOI: 10.1016/j.jtct.2022.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
During the COVID-19 pandemic, donor grafts are frequently cryopreserved to ensure that a graft is available before starting a conditioning regimen. However, there have been conflicting reports on the effect of cryopreservation on transplantation outcomes. Also, the impact of cryopreservation may differ in bone marrow (BM) transplantation (BMT) and peripheral blood stem cell (PBSC) transplantation (PBSCT). In this retrospective study, we analyzed the clinical data of both cryopreserved unrelated BMTs (n = 235) and PBSCTs (n = 118) and compared these with data from a large control cohort without cryopreservation including 4133 BMTs and 720 PBSCTs. Among the patients with cryopreserved grafts, 10 BMT recipients (4.3%) and 3 PBSCT recipients (2.5%) did not achieve neutrophil engraftment after transplantation, including 4 of the former and all 3 of the latter who died early before engraftment. In a multivariate analysis, cryopreservation was not associated with neutrophil engraftment in BMT but significantly delayed neutrophil engraftment in PBSCT (hazard ratio [HR], .82; 95% confidence interval [CI], .69 to .97; P = .023). There was an interaction with borderline significance between cryopreservation and the stem cell source (P = .067). Platelet engraftment was delayed by cryopreservation after both BMT and PBSCT. Only 2 cryopreserved grafts (<1%) were unused during the study period. The cryopreservation of unrelated donor BM and PBSC grafts is associated with a slight delay in neutrophil and platelet engraftment but an acceptable rate of graft failure. PBSC grafts may be more sensitive to cryopreservation than BM grafts. Cryopreservation is a reasonable option during COVID-19 pandemic, provided that the apheresis and transplantation centers are adept at cryopreservation. © 2022 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
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Affiliation(s)
- Yoshinobu Kanda
- Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan.
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Minoru Kojima
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Shinichi Kako
- Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Osaka, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Yasushi Onishi
- Department of Hematology, Tohoku University Hospital, Sendai, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Reiko Kamata
- Nonprofit Organization Blood Disorder Information and Support Service "Tsubasa", Tokyo, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Mika Kotaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Ryoji Kobayashi
- Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Sapporo, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Junji Tanaka
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Nobuharu Fujii
- Division of Blood Transfusion, Okayama University Hospital, Okayama, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Koichi Miyamura
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Shin-Ichiro Mori
- Hematology Department, St. Luke's International Hospital, Tokyo, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Yasuo Mori
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Yasuo Morishima
- Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University School of Medicine, Nagakute, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Hiromasa Yabe
- Department of Innovative Medical Science, Tokai University School of Medicine, Isehara, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan; Medical Committee of the Japan Marrow Donor Program, Tokyo, Japan
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13
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Impact of Cryopreservation and Freeze-Thawing on Therapeutic Properties of Mesenchymal Stromal/Stem Cells and Other Common Cellular Therapeutics. CURRENT STEM CELL REPORTS 2022; 8:72-92. [PMID: 35502223 PMCID: PMC9045030 DOI: 10.1007/s40778-022-00212-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 12/19/2022]
Abstract
Purpose of Review Cryopreservation and its associated freezing and thawing procedures–short “freeze-thawing”–are among the final steps in economically viable manufacturing and clinical application of diverse cellular therapeutics. Translation from preclinical proof-of-concept studies to larger clinical trials has indicated that these processes may potentially present an Achilles heel to optimal cell product safety and particularly efficacy in clinical trials and routine use. Recent Findings We review the current state of the literature on how cryopreservation of cellular therapies has evolved and how the application of this technique to different cell types is interlinked with their ability to engraft and function upon transfer in vivo, in particular for hematopoietic stem and progenitor cells (HSPCs), their progeny, and therapeutic cell products derived thereof. We also discuss pros and cons how this may differ for non-hematopoietic mesenchymal stromal/stem cell (MSC) therapeutics. We present different avenues that may be crucial for cell therapy optimization, both, for hematopoietic (e.g., effector, regulatory, and chimeric antigen receptor (CAR)-modified T and NK cell based products) and for non-hematopoietic products, such as MSCs and induced pluripotent stem cells (iPSCs), to achieve optimal viability, recovery, effective cell dose, and functionality of the cryorecovered cells. Summary Targeted research into optimizing the cryopreservation and freeze-thawing routines and the adjunct manufacturing process design may provide crucial advantages to increase both the safety and efficacy of cellular therapeutics in clinical use and to enable effective market deployment strategies to become economically viable and sustainable medicines.
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