Successful allogeneic cryopreserved marrow transplantation

Abstract

Cryopreservation has been used extensively in autologous marrow transplantation (BMT), but there has been limited use in allogeneic BMT. We describe here 6 cases of successful engraftment following allogeneic BMT with cryopreserved marrow. Patients suffered from Wiscott-Aldrich syndrome, osteopetrosis, aplastic anemia, and acute lymphocytic, acute non-lymphocytic, and chronic myelogenous leukemia, and ranged in age from 5 mos to 35 yrs. Marrow was collected using standard techniques. In one case T-cells were removed to prevent graft-vs-host disease. Marrow was frozen for a variety of reasons. Buffy coat cells were frozen at controlled rate in 10% DMSO, and stored in liquid nitrogen for 6 to 49 d. Engraftment (WBC greater than 1000/uL x 3 d) occurred from 13 to 37 d post BMT. In 4 of 4 cases in which data are available, donor origin of engraftment was documented, 1 with cytogenetics, 2 with red cell typing, and 4 with restriction fragment length polymorphisms. 3 patients are alive and well 21, 21, and 42 months post BMT. These results suggest frozen marrow can be successfully used for allogeneic BMT.

Transportation and cryopreservation may impair haematopoietic stem cell function and engraftment of allogeneic PBSCs, but not BM

“…[1][2][3][4][5][6][7] In a retrospective study we analysed functionality (ALDH activity and CFU) vs CD34 positivity and MI in 31 consecutive allogeneic PBSC and 8 allogeneic BM grafts frozen in our hospital between 2000 and 2007. Clinical data including leucocyte engraftment and chimaerism kinetics were available for 33 PBSC and 13 BM patients transplanted with those grafts.…”

“…Since cryopreservation is not a standard procedure with allogeneic transplants, [1][2][3][4][5][6][7] the number of allografts analysed in this study was limited. However, between 2000 and 2007, 36 allogeneic PBSC and 13 allogeneic BM grafts had to be frozen due to medical and/or logistic reasons in our hospital.…”

“…1 However, until now the few clinical studies published on this topic did only compare fresh vs frozen BM-derived allografts. [2][3][4][5][6][7] There are no reported outcomes for recipients of cryopreserved allogeneic PBSC grafts. Based on reviewed literature, Frey et al 1 suggest that the available data do not yet sufficiently justify the dogmatic use of fresh over frozen allografts.…”

Cryopreservation of allogeneic PBSC from related and unrelated donors is associated with delayed platelet engraftment but has no impact on survival

“…Diagnoses defined as 'myeloid' were (n): AML (101), myelodysplastic syndrome (16), CML (14), myelofibrosis (6); diagnoses considered 'lymphoid' were (n): non-Hodgkin's lymphoma (34), ALL (17), Hodgkin's lymphoma (10), CLL (5), myeloma (5) and aplastic anaemia (2). Neutrophil and platelet engraftment were defined as time from day 0 until the first of 3 consecutive days when ANC exceeded 0.5 Â 10 9 /L and platelet count exceeded 50 Â 10 9 /L without platelet transfusion support, respectively.…”

“…[2][3][4][5][6] Only one study has examined cryopreserved PBSC allo-SCT in depth; 7 105 patients receiving cryopreserved PBSC allo-SCT were compared with a historical control receiving fresh PBSC. There were no differences in neutrophil or platelet engraftment time, acute or chronic GVHD incidences nor in survival, relapse and TRM-however, it is important to note that no unrelated donors were included in this series.…”