Long‐term follow‐up of leukaemia patients after related cryopreserved allogeneic bone marrow transplantation

Abstract

Summary.We have previously shown that allogeneic bone marrow transplantation (BMT) with cryopreserved donor marrow cells can be used without prolonging the engraftment time or interfering with the reconstitution of haemopoiesis. In this report we extend our initial observations of the first 40 patients who underwent allogeneic bone marrow transplantation from related donors with cryopreserved donor bone marrow for haematological malignancies, including the long-term follow-up data of the previously reported patients. The outcome of these patients was compared with that of 40 related BMT recipients receiving fresh donor bone marrow (historic control group). Time until engraftment of all patients receiving cryopreserved bone marrow was not different from the control group (ANC > 0 . 5 × 10 69 d), respectively). There was the same incidence of acute and chronic GvHD in patients receiving either cryopreserved bone marrow or fresh bone marrow (acute GvHD у II 61% v 60% and chronic GvHD 56% v 52%, respectively). Chimaerism studies showed no difference between the patient groups. Furthermore, the two groups did not differ in day 100 survival (82% v 72%). With a median follow-up of 520 d (range 47-1365 d) and 1289 d (range 48-1849 d), 60% of the patients receiving cryopreserved and 53% of the patients receiving fresh allogeneic donor bone marrow, respectively, are alive. We conclude that cryopreservation of allogeneic related donor bone marrow does not adversely affect engraftment, does not decrease the incidence of severe acute GvHD, and does not seem to affect the day 100 survival or long-term haemopoiesis.

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

“…4,5,7 In Stockschläder's studies, 4,5 the stem cell source was BM and this may account for the difference, as PBSC are associated with earlier platelet engraftment than BM. 10,11 The median times to platelet engraftment (19 and 14 days to 450 Â 10 9 /L) reported here are earlier than those in Stockschläder's study, where times to platelet count 420 Â 10 9 /L were 22 and 21 days for cryopreserved and fresh BM.…”

“…[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.…”

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.…”