Veno-occlusive disease of the liver (VOD) is an important complication in hematological transplantation. The aim of this study is to analyze the risk factors for VOD and other forms of liver toxicity in a cohort of 180 peripheral stem cell transplants performed in our Center. We find that elevated pretransplant levels of serum ferritin are the most important risk marker for VOD. We believe that ferritin reflects damage induced by oxygen radicals resulting from iron-mediated catalysis. We also discuss different risk factors for VOD and other forms of liver toxicity, suggesting diferent pathogenic mechanisms.

Summary:In order to assess the potential clinical benefit of filgrastim (G-CSF) after peripheral blood stem cell (PBSC) autotransplantation a randomized study was begun in our center in July 1997: 62 patients were involved (30 received filgrastim after PBSC infusion and 32, the control group, received no cytokines). All were adults (median 40 years, range 18-65). Patients with one of three different pathologies were recruited: 28 had advanced breast carcinoma, 23 had lymphomas (12 Hodgkin's disease and 11 non-Hodgkin's lymphoma) and 11 had de novo AML. All of them were transplanted using myeloablative chemotherapy conditioning regimens. G-CSF was administered subcutaneously from day +5 in the treated group at a dose of 5 g/kg body weight/day. The numbers of CD34 + and mononuclear (MNC) cells infused were similar in each group. Only minor differences regarding the use of G-CSF could be inferred from the analysis of the data. Faster granulocyte engraftment was evident in the treated group (mean of 10 vs 12 days to achieve Ͼ0.5 × 10 9 /l granulocytes, P = 0.0008), without differences in incidence and severity of infections, days of fever or duration of antibiotic treatment between groups. There was slightly slower platelet engraftment (mean of 15 days in the group with G-CSF vs 12 days in the other group to achieve Ͼ20 × 10 9 /l platelets, P = NS) in this series, but there were no differences in incidence and severity of haemorrhage or platelet transfusion support. Considering the economical costs, the median expenditure per inpatient stay was Eur5961 (range Eur4386-Eur17186) in the G-CSF group compared with Eur5751 (range Eur3676-Eur15640) in the control group (P = 0.47). From our data it could be concluded that for adult patients transplanted with PBSC there is no clear beneficial impact of post-infusion G-CSF administration.

Summary:A simplified cryopreservation method for bone marrow (BM) and peripheral blood progenitor cells (PBPC) was utilized in hematopoietic cell transplantation of 213 patients with hematological or solid neoplasms after ablative chemotherapy (187 with peripheral blood progenitor cells and 26 with bone marrow). Cells were cryopreserved, after addition of autologous fresh plasma with DMSO, without HES, by freezing to ؊80؇C in a methanol bath and non-programmed freezer. For the patients autotransplanted with PBPC, the median period necessary for recovery of more than 0.5 × 10 9 /l granulocytes was 11 days (range 6-44), and 15 (8-204) days were required to obtain more than 20 × 10 9 /l platelets. For the patients autotransplanted with BM, the median period necessary to recover Ͼ0.5 × 10 9 /l granulocytes was 12 days (range 9-33), and 24 (12-57) days to obtain more than 20 × 10 9 /l platelets. These results support this method as being very effective in achieving high-quality cryopreservation. The procedure, which uses a non-programmed freezer, simplifies and reduces enormously the cost of the technical measures currently in use, enabling its adoption in almost any clinical oncological institution. Keywords: hematopoietic cell transplantation; cryopreservation; plasma and DMSO; non-programmed freezing; methanolThe transplantation of hematopoietic progenitor cells, derived both from bone marrow and peripheral blood, is an ever more frequent procedure in the treatment of numerous neoplastic diseases. The technology for this type of therapeutic procedure requires, in the majority of cases, the freezing and storage of these cells for variable periods of time. The freezing procedure is traditionally carried out using machinery which incorporates pre-established, comCorrespondence: Dr F Hernández-Navarro, Servicio Hematología y Hemoterapia, Hospital La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain Received 7 July 1997; accepted 21 October 1997 puterized freezing programs. 1-4 Experience using direct or non-programmed freezing systems for hemotopoietic progenitor cells and their transplant is less widespread. [5][6][7][8][9][10][11] In this article, we summarize our experience using a simple, non-programmed freezing method for the transplant of hematopoietic cells in patients with neoplastic disease. Two different in vitro experiments were designed to analyze the reproducibility and the effect of the methanol bath on freezing rates. Finally, a limited comparative study of in vitro cell viability following programmed and non-programmed freezing is also presented. Materials and methods Cooling ratesIn order to analyze the reproducibility of the cooling rates with the methanol system and the impact of this technique on the standardization of the freezing, two different in vitro experiments were performed.In the first (Figure 1), four different bags containing 160 ml of hematopoietic cells in 10% DMSO and autologous plasma were cryopreserved using a mechanical freezer at Ϫ80°C in a methanol bath as previously describe...

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