Comparison of allogenic stem cell transplantations performed with frozen or fresh stem cell products with regard to GVHD and mortality

Dağdaş, Simten; Uçar, Mehmet Ali; Ceran, Funda; Güneş, Ahmet Kürşad; Falay, Mesude; Özet, Gülsüm

doi:10.1016/j.transci.2020.102742

Cited by 14 publications

(13 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study showed delayed platelet engraftment in cryopreserved-related donor PBSC grafts and delayed engraftment of both neutrophils and platelets in cryopreserved unrelated donor PBSC grafts. Dagdas et al also showed longer neutrophil engraftment kinetics using frozen products [11].…”

Section: Discussionmentioning

confidence: 93%

“…Cryopreservation of PBSC is not a common practice in allogenic transplantation apart from umbilical cord blood transplantation [11], and concerns regarding cryopreserved products adversely affecting cell viability and effector cell function has been the main reason for performing fresh allograft infusions in these patients [14]. We retrospectively assessed the impact of cryopreservation on patient outcomes during the COVID-19 pandemic in the year 2020.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is plenty of evidence on the safety and efficacy of cryopreserved autograft [5], data on the outcomes of cryopreserved allo-HSCT has been mixed and limited [2][3][4][5][6][7][8][9][10][11][12][13][14]. Some studies showed increased risk of graft failure and higher mortality rate, while others showed no impact on survival or engraftment.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cryopreserved versus fresh peripheral blood allogeneic stem cell transplantation outcomes in patients receiving post-transplant cyclophosphamide for graft-versus-host prophylaxis during the COVID-19 pandemic: a single center experience

et al. 2022

View full text Add to dashboard Cite

Background/objective Cryopreservation of grafts is not common practice in allogeneic hematopoietic stem cell transplant (HSCT) recipients. However, our center had to use cryopreserved cells for allogeneic HSCT during the COVID-19 pandemic to avoid delays in transplantation due to uncertainty regarding patient and donor exposures. Study designWe retrospectively evaluated post-transplant engraftment and survival outcomes of adult patients who received cryopreserved versus fresh allografts during the COVID-19 pandemic. Results Fifty-five patients with hematologic malignancies received either cryopreserved (n = 34) or fresh (n = 21) allogeneic HSCT using peripheral blood stem cells between January 2020 and December 2020. At a median follow-up time of 15 months, cryopreserved allograft recipients had significantly lower overall survival (OS) (p = 0.02). They also experienced significantly delayed neutrophil (p = 0.01) and platelet engraftments (p < 0.0001), as well as higher red blood cell transfusiondependence after day + 60 (67.6% vs. 28.6%; p = 0.01). Significantly more cryopreserved allograft recipients received donor lymphocyte infusion than fresh allograft recipients (35.3% vs. 4.8%, p = 0.01). Neither relapse-free survival nor non-relapse mortality differed significantly between the two groups. Conclusion Cryopreservation of allografts in combination with post-transplant cyclophosphamide may negatively affect engraftment and OS outcomes in HSCT recipients.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cryopreserved versus fresh peripheral blood allogeneic stem cell transplantation outcomes in patients receiving post-transplant cyclophosphamide for graft-versus-host prophylaxis during the COVID-19 pandemic: a single center experience

et al. 2022

View full text Add to dashboard Cite

show abstract

“…As mentioned above, during the first wave of COVID-19 pandemic in March 2020, cryopreservation of harvested HSCs became a standard of care, although associated with a theoretical negative impact on graft quality it can lead to. This issue was already addressed in multiple studies before the COVID-19 pandemic, showing no significant difference in overall survival (OS) nor in progression-free survival (PFS) between fresh and cryopreserved grafts (47)(48)(49)(50)(51), including cases with GVHD prevention by PTCy (52). Similar results were reported in studies conducted during the COVID-19 pandemic (53,54).…”

Section: Impact and Interest Of Stem Cell Cryopreservationmentioning

confidence: 57%

Allogeneic hematopoietic stem cell transplantation in the COVID-19 era

Bordat

Maury²,

Leclerc³

2023

Front. Immunol.

View full text Add to dashboard Cite

Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) recipients are especially vulnerable to coronavirus disease 19 (COVID-19), because of their profound immunodeficiency. Indeed, the first pandemic wave was marked by a high mortality rate in this population. Factors increasing immunodepression such as older age, immunosuppressive treatments or a short delay between transplant and infection appear to worsen the prognosis. Many changes in clinical practice had to be implemented in order to limit this risk, including postponing of transplant for non-malignant diseases, preference for local rather than international donations and for peripheral blood as stem cell source, and the widespread use of cryopreservation. The great revolution in the COVID-19 pandemic came from the development of mRNA vaccines that have shown to be able to prevent severe forms of the disease. More than 75% of allo-HSCT recipients develop seroconversion after 2 doses of vaccine. Multiple studies have identified lymphopenia, exposure to immunosuppressive or anti-CD20 therapies, and a short post-transplant period as factors associated with a poor response to vaccination. The use of repeated injections of the vaccine, including a third dose, not only improves the seroconversion rate but also intensifies the immune response, both in B cells and T cells. Vaccines are an effective and well-tolerated method in this high-risk population. Some studies investigated the possibility of immune protection being transferred from a vaccinated donor to a recipient, with encouraging initial results. However, dynamic mutations and immune escape of the virus can lead to breakthrough infections with new variants in vaccinated individuals and still represent a threat of severe disease in allo-HSCT recipients. New challenges include the need to adapt vaccine protection to emerging variants.

show abstract

“…Microbiologically documented infection occurred in only 21% of patients, and clinically suspected infections without a clear infectious agent occurred in 7% of patients [4]. Before engraftment, fever occurs in nearly all patients undergoing allogeneic HCT [5].…”

Section: Frequency Of Fever Associated With Hematopoietic Cell Transp...mentioning

confidence: 99%

Noninfectious causes of fever in hematologic malignancies. Are antibiotics still indicated?

Shahid

Epstein

2023

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Purpose of review Fever is a common manifestation of both infectious and noninfectious processes in recipients of hematopoietic cell transplantation (HCT) and chimeric antigen receptor T-cell (CAR-T) therapy. Understanding the diverse causes of fever in these settings allows for accurate diagnosis and optimal use of antibiotics. Recent findings Herein we review common noninfectious syndromes seen in HCT and CAR-T recipients and discuss best practices in the management of these complex clinical scenarios regarding diagnosis and antibiotic use. In recent years, adverse effects of antimicrobials have highlighted the importance of antimicrobial stewardship in HCT and CAR-T patients, and an antibiotic de-escalation strategy is a safe and important tool in mitigating these adverse events, even in patients with ongoing neutropenia who become afebrile without a known infection. Common adverse events associated with antibiotics include an increased risk of Clostridiodes difficile infection (CDI), a higher incidence of multidrug-resistant organisms (MDROs), and microbiome dysbiosis. Summary Clinicians should be aware of noninfectious causes of fever in these immunocompromised patients and utilize best antibiotic practices while managing these patients.

show abstract

Comparison of allogenic stem cell transplantations performed with frozen or fresh stem cell products with regard to GVHD and mortality

Cited by 14 publications

References 26 publications

Cryopreserved versus fresh peripheral blood allogeneic stem cell transplantation outcomes in patients receiving post-transplant cyclophosphamide for graft-versus-host prophylaxis during the COVID-19 pandemic: a single center experience

Cryopreserved versus fresh peripheral blood allogeneic stem cell transplantation outcomes in patients receiving post-transplant cyclophosphamide for graft-versus-host prophylaxis during the COVID-19 pandemic: a single center experience

Allogeneic hematopoietic stem cell transplantation in the COVID-19 era

Noninfectious causes of fever in hematologic malignancies. Are antibiotics still indicated?

Contact Info

Product

Resources

About