We sought to evaluate the impact of cryopreservation of unrelated donor peripheral blood stem cell (PBSC) grafts on engraftment, chimerism, and immune reconstitution in the context of the Covid-19 pandemic. We reviewed stem cell product characteristics and clinical outcomes in 101 patients receiving cryopreserved PBSCs from unrelated donors (URD) between January 1, 2019, and December 31, 2020, compared with 203 patients receiving fresh URD PBSCs. We observed no differences in 6-month overall survival, progression free survival, or non-relapse mortality. Patients receiving cryopreserved PBSCs had delayed platelet engraftment and impaired reconstitution of white blood cells and T cell subsets at Day 30. Thirty-four percent of patients receiving cryopreserved grafts had CD3 chimerism <50% at Day 30 after transplantation, compared with 14% of patients receiving fresh PBSCs (p=0.0002). At day 100, this difference persisted (CD3+ chimerism <50%: 17% of cryopreserved cohort vs 6% of fresh cohort, p=0.016). Additionally, greater product age at infusion is associated with an increase in graft failure, independent of cryopreservation. Receipt of grafts >48 hours old at time of cryopreservation or infusion significantly increased the risk of graft failure (sHR =4.57 (95% CI 1.71-12.3), p=0.0025). Our data indicate that cryopreservation is associated with similar overall short-term clinical outcomes compared to fresh PBSC. However, patients must be monitored closely for increased risk of other potentially adverse outcomes including graft failure and poor immune recovery, particularly for grafts with older overall age at infusion. Longer term follow-up is needed to determine impact on relapse and survival.

IntroductionNothing has been published to describe the practices of medical societies in choosing abstracts for presentations at their annual meetings. We surveyed medical societies to determine their practices, and also present a theoretical analysis of the topic.MethodsWe contacted a convenience sample of large U.S. medical conferences, and determined their approach to choosing abstracts. We obtained information from web sites, telephone, and email. Our theoretical analysis compares values-based and empirical approaches for scoring system development.ResultsWe contacted 32 societies and obtained data on 28 (response rate 88%). We excluded one upon learning that research was not presented at its annual meeting, leaving 27 for analysis. Only 2 (7%) made their abstract scoring process available to submitters. Reviews were blinded in most societies (21;78%), and all but one asked reviewers to recuse themselves for conflict of interest (96%). All required ≥3 reviewers. Of the 24 providing information on how scores were generated, 21 (88%) reported using a single gestalt score, and three used a combined score created from pooled domain-specific sub-scores. We present a framework for societies to use in choosing abstracts, and demonstrate its application in the development of a new scoring system.ConclusionsMost medical societies use subjective, gestalt methods to select research for presentation at their annual meetings and do not disclose to submitters the details of how abstracts are chosen. We present a new scoring system that is transparent to submitters and reviewers alike with an accompanying statement of values and ground rules. We discuss the challenges faced in selecting abstracts for a large scientific meeting and share the values and practical considerations that undergird the new system.

A recent population-based analysis demonstrated lower risk of the lethal degenerative neuromuscular disease, amyotrophic lateral sclerosis (ALS) associated with history of the use of 'antineoplastic agents' and 'immunosuppressants'. To see if this finding was generalizable to other ALS cohorts, we examined associations between use of these agents and ALS risk in an independent case-control study of n = 414 ALS patients and n = 361 controls in an Eastern US population. Controls were sampled from the general population and among non-neurodegenerative disease patients. A history of chemotherapy treatment was significantly associated with a decreased ALS risk (OR 0.46, 95% CI 0.22-0.89, P = 0.026). We did not observe an association between risk of ALS and immunosuppressant therapy use (OR 0.78, 95% CI 0.50-1.02, P = 0.23). Analyses were adjusted for age, gender, and smoking. Our results support the prior report for chemotherapy treatment and lead to further discussion of the underlying mechanism.

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