Influence of laboratory procedures on postthawing cell viability and hematopoietic engraftment after autologous peripheral blood stem cell transplantation

Autor: Roberta Kelly de Andrade, André Rolim Belisário, Nathália Gomide Cruz, Junio Rocha Luz, Karen de Lima Prata, Paula Renata Machado Passos Pederzoli, Marcia Regina Issa Salomão Libânio, Luciana de Almeida Costa, Ana Paula da Costa Funes, Maurício Colombini Martins, Marina Dos Santos Brito Silva Furtado
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Cryoprotectant
Platelet Engraftment
Cell Survival
Immunology
Urology
030204 cardiovascular system & hematology
Hydroxyethyl starch
Transplantation
Autologous
Cryopreservation
Specimen Handling
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Autologous stem-cell transplantation
Freezing
Humans
Immunology and Allergy
Medicine
Viability assay
Multiple myeloma
Aged
Retrospective Studies
Peripheral Blood Stem Cell Transplantation
Neutrophil Engraftment
business.industry
Hematopoietic Stem Cell Transplantation
Professional Practice
Hematology
Middle Aged
Hematopoietic Stem Cells
medicine.disease
Hematopoietic Stem Cell Mobilization
Treatment Outcome
Peripheral Blood Stem Cells
Female
Laboratories
Multiple Myeloma
business
030215 immunology
medicine.drug
Zdroj: Transfusion. 61:1202-1214
ISSN: 1537-2995
0041-1132
Popis: Background The kinetics of hematopoietic recovery after autologous stem cell transplantation (ASCT) may be affected by laboratory procedures. The aim of this study was to evaluate the influence of characteristics of the cryopreserved units of peripheral blood stem cells (PBSC) on postthawing cell viability and engraftment outcomes after ASCT. Study design and methods This was a retrospective cohort study including individuals referred for ASCT. Cryopreservation was conducted at a single processing facility between 2014 and 2019, and patients received clinical care at six transplant centers. Covariates and outcome data were retrieved from participants' records. Results The study population comprised 619 patients (345 [55.7%] male). Median age was 53 years. Multiple myeloma was the most common diagnosis (62.7%). Higher preapheresis CD34+ cell count, lower nucleated cell (NC) concentration per cryobag, and composition of the cryoprotectant solution (5% dimethyl sulfoxide [DMSO] and 6% hydroxyethyl starch) were statistically significantly associated with higher postthawing cell viability. The linear regression model for time to neutrophil and platelet engraftment included the infused CD34+ cell dose and the composition of the cryoprotectant solution. Patients who had PBSC cryopreserved using 10% DMSO solution presented six times higher odds (odds ratio [OR] = 6.9; 95% confidence interval [CI]: 2.2-21.1; p = .001) of delayed neutrophil engraftment (>14 days) and two times higher odds (OR = 2.3, 95%CI: 1.4-3.7; p = .001) of prolonged hospitalization (>18 days). Discussion The study showed that mobilization efficacy, NC concentration, and the composition of the cryoprotectant solution significantly affected postthawing cell viability. In addition, the composition of the cryoprotectant solution significantly impacted engraftment outcomes and time of hospitalization after ASCT.
Databáze: OpenAIRE
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