Cryopreserved versus non-cryopreserved peripheral blood stem cells for autologous transplantation after high-dose Melphalan in multiple myeloma: comparative analysis

Bittencourt, Maria Cecilia Borges; Mariano, Lívia Caroline Barbosa; Moreira, Fernando Alves; Schmidt-Filho, Jayr; Mendrone-Jr, Alfredo; Rocha, Vanderson

doi:10.1038/s41409-018-0250-1

Cited by 13 publications

(14 citation statements)

References 18 publications

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“…There was no difference in outcome OS and PFS in the two groups. This was consistent with earlier observations from our centre22 and those reported recently31. No difference was observed in outcome of patients who received ≤4 million CD34+ stem cells or more.…”

Section: Discussionsupporting

confidence: 93%

High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome

et al. 2019

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Background & objectives:Survival of patients with multiple myeloma (MM) has improved in the past two decades following use of novel agents and autologous stem cell transplantation. To determine predictors of long-term outcome, data of MM patients who underwent autologous stem cell transplantation (ASCT) at a tertiary care centre in north India were retrospectively analyzed.Methods:Between 1995 and 2016, 349 MM patients underwent ASCT. Patients' median age was 52 yr, ranging from 29 to 68 yr, 68.2 per cent were males. Thirty three per cent patients had international staging system (ISS) Stage III and 68.5 per cent had received novel agents-based induction. High-dose melphalan (200 mg/m2) was used for conditioning; patients with renal insufficiency (estimated glomerular filtration rate <40 ml/min) received melphalan 140-150 mg/m2.Results:Post-transplant, 317 of 349 (90.8%) patients responded; complete [complete response (CR)] −213 (61%)], very good partial response (VGPR) −62 (17.8%) and PR in 42 (12%)]. Induction with novel agents, pre-transplant chemosensitive disease, transplant in first remission and serum albumin (≥3.5 g/dl) were predictors of significant response. At a median follow up of 73 months, median overall survival (OS) was 90 months [95% confidence interval (CI) 70.8-109.2], and progression-free survival (PFS) was 41 months (95% CI 33.0-49.0). On multivariate analysis, achievement of CR post-transplant, transplant in first remission, ISS Stages I and II (vs. III), absence of extramedullary disease and serum albumin ≥3.5 g/dl were predictors of prolonged OS. For PFS, achievement of post-transplant CR and transplant in first remission were predictors of superior outcome.Interpretation & conclusions:Treatment with novel agents, achievement of complete remission post-transplant, ISS Stages I and II, absence of extramedullary disease and transplant in first remission were predictors of long-term survival for patients with MM.

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Section: Discussionsupporting

confidence: 93%

High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome

et al. 2019

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“…Our study has assessed the feasibility of fresh autotransplantation for MM patients. Previous studies support the use of PBSC grafts stored at 4°C for MM autologous transplantation 3–5,11–13 . We have compared patients who received a fresh or cryopreserved PBSC autotransplant for MM in a single study center.…”

Section: Discussionmentioning

confidence: 99%

“…However, the fresh maintenance of PBSC is possible while the patient receives the conditioning regimen 2 . Moreover, studies have shown that autologous transplantation with non‐cryopreserved PBSC can be safe and present better outcomes, such as earlier neutrophilic grafting, fewer cases of infusion‐related complications, 3,4 early platelets engraftment, lower incidence of neutropenic fever, less mucositis, fewer days using antibiotic, and less requirement for parenteral nutrition and opioids 3 . Besides the clinical advantages, non‐cryopreserved transplants can reduce laboratory and hospital expenses 4,5 .…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, studies have shown that autologous transplantation with non‐cryopreserved PBSC can be safe and present better outcomes, such as earlier neutrophilic grafting, fewer cases of infusion‐related complications, 3,4 early platelets engraftment, lower incidence of neutropenic fever, less mucositis, fewer days using antibiotic, and less requirement for parenteral nutrition and opioids 3 . Besides the clinical advantages, non‐cryopreserved transplants can reduce laboratory and hospital expenses 4,5 . Many factors can contribute to the negative effects of cryopreserved cells, such as the clinical symptoms of DMSO exposure (nausea, vomiting, abdominal cramps, headaches, 6 hypo or hypertension, bradycardia, hemolysis, rashes, renal failure, pulmonary edema, bronchospasm, cardiac arrest, and neurological damage 7–9 ), cell debris, cell aggregation, red blood cell lysis products, electrolyte imbalance, and the requirement of adjustable CD34+ collection goals, considering the cellular losses due to the cryopreservation/thawing process.…”

Section: Introductionmentioning

confidence: 99%

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Non‐cryopreserved peripheral blood stem cells as a safe and effective alternative for autologous transplantation in multiple myeloma

et al. 2022

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Background: Autologous stem cell transplantation is the standard procedure for multiple myeloma and the grafts are usually cryopreserved. Previous studies reported advantages in the use of fresh peripheral blood stem cells (PBSC) autotransplantation compared to cryopreservation of the grafts. This study compared the transplant-related outcomes of two graft preservation methods: fresh storage (4°C/72 h) and cryopreservation (À80°C).

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“…However, it was shown very early on that marrow could not be preserved for more than 56 h [18]. In contrast, and more recently, it was observed that peripheral blood stem cell (PBSC) collected and somewhat purified by leukapharesis (LK), can survive storage at 4°C for up to 6 days but not longer, enabling carefully planned autografts to be performed in patients receiving short pre-transplant regimens [19][20][21][22][23][24]. Stem cell cryopreservation opened the door for autologous transplantation and a decade later to cord blood storage.…”

Section: Cryopreservation Of Stem Cellsmentioning

confidence: 99%

History and Development of Autologous Stem Cell Transplantation for Acute Myeloid Leukemia

Gorin¹

2021

CHI

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This review describes the development of cryopreservation, the birth of autologous stem cell transplantation (ASCT) and its past and present use to consolidate adult patients with acute myelogenous leukemia (AML). It summarizes the first autografts in patients in relapse, the experience of autografting in complete remission (CR), using bone marrow unpurged or purged in vitro with cyclophosphamide-derivatives, and the important shift to peripheral blood stem cells. The review also discusses the results of recent studies in favor of the use of ASCT to consolidate good-and intermediate-risk patients who reach CR with no detectable minimal residual disease, and those which support the inclusion of maintenance therapy post autograft with hypomethylating agents, anti-BCL-2, and, possibly, in the future, anti AML chimeric antigen receptor-T cells. Carefully applied to well-selected patients, ASCT may regain interest, because of its simplicity, its reduced toxicity, lower non-relapse mortality and better quality of life.

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Cryopreserved versus non-cryopreserved peripheral blood stem cells for autologous transplantation after high-dose Melphalan in multiple myeloma: comparative analysis

Cited by 13 publications

References 18 publications

High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome

High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome

Non‐cryopreserved peripheral blood stem cells as a safe and effective alternative for autologous transplantation in multiple myeloma

History and Development of Autologous Stem Cell Transplantation for Acute Myeloid Leukemia

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