Hematologic, immunologic reconstitution, and outcome of 342 autologous peripheral blood stem cell transplantations after cryopreservation in a -80°C mechanical freezer and preserved less than 6 months

Transfusion. 2013 Mar;53(3):570-8. doi: 10.1111/j.1537-2995.2012.03768.x. Epub 2012 Jul 15.

Abstract

Background: Controlled-rate freezing and storage in nitrogen is the standard technique for cryopreservation of peripheral hematopoietic progenitor cells (PHPCs) but presents high cost and dimethyl sulfoxide (DMSO) toxicity. Cryopreservation at -80°C, by uncontrolled rate freezing with only 3.5% DMSO, preserves the functional capacities of PHPCs, produces successful engraftment, and reduces toxicity during infusion.

Study design and methods: Long-term hematopoietic and immunologic reconstitution for 342 autografts (311 adults, 31 children) after PHPCs were cryopreserved at -80°C was studied at 3, 6, and 12 months. The median (range) storage time of PHPCs cryopreserved was 1.7 (0.1-5.99) months.

Results: Hemoglobin (Hb), white blood cells, and platelets (PLTs) reach normal values to trilineage at 12 months for 39% patients. Multivariate analysis shows a significant impact on CD34+ infused and on conditioning regimen for PLTs. Hb was influenced by growth factor administration at 3 months. Long-term recovery is also highly dependent on blood counts (Hb, PLT, and neutrophil) at start of high-dose chemotherapy. Only 43% of patients had reached normal lymphocyte values at 12 months after transplant, and a profound CD4+ T-lymphocyte deficit remained, as others reported.

Conclusion: Transplantation with PHPCs cryopreserved at -80°C for no more than 6 months is satisfactory for long-term hematopoietic and immunologic reconstitution, even if a profound CD4+ T lymphocyte deficit persists at 1 year. This easier and cheaper cryopreservation method also leads to successful engraftment.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Preservation* / adverse effects
  • Blood Preservation* / instrumentation
  • Blood Preservation* / methods
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cryopreservation* / methods
  • Female
  • Freezing / adverse effects
  • Graft Survival
  • Hematopoiesis / physiology*
  • Hematopoietic Stem Cells / physiology
  • Humans
  • Immunity / physiology*
  • Infant
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation* / methods
  • Time Factors
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult