Lower incidence of chronic GVHD observed after transplantation with cryopreserved unrelated allogeneic stem cells

Pros and Cons of Cryopreserving Allogeneic Stem Cell Products

“…In fact, although early clinical outcomes did not appear to be compromised, low T cell chimerism and impaired immune reconstitution could affect longer-term outcomes [ 54 ]. These results were further confirmed in a subsequent report involving a larger population size and an extended observation period [ 95 ]. Additional information on longer-term outcomes was provided, showing that cryopreserved and fresh graft transplants had a similar OS and relapse rate, but cryopreserved graft recipients had a lower incidence of chronic GvHD, either any grade or II–IV grade [ 95 ].…”

“…In total, 1739 references were identified on 15 January 2024. In the end, 29 papers were included [ 54 , 55 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 ] ( Figure 1 ).…”

“…Maurer et al illustrated the allo-transplant activity data at the Dana-Farber Cancer Institute during the first 3 months of the pandemic. The authors compared outcomes at day +100 of 64 related and unrelated adult transplants with two control groups: 68 transplants performed in the 3 months prior to the pandemic and an additional 76 transplants treated in the 12 months prior to the pandemic [ 95 ]. Regarding donor selection, there was a trend for an increase in domestic versus international unrelated donations.…”

“…Notably, in studies of Parody et al [ 89 ] and Maurer et al [ 54 ], no or a few patients received PTCy, respectively, a drug which prevents aGvHD by favoring the selection of the T-reg subset [ 54 ]. On the contrary, in the setting of cGvHD, several studies found that severity and incidence may be reduced with cryopreserved grafts even in patients receiving PTCy [ 91 , 100 , 110 ], whereas this effect has also been observed when GvHD prophylaxis is carried out with other agents [ 93 , 95 ]. In the only study reporting an increased incidence of cGvHD with cryo-grafts, this observation could have been biased by the higher rate of in vivo T cell depletion in the fresh graft group [ 99 ].…”

“… Days to neutrophil and platelet recovery [ 86 , 88 , 89 , 91 , 92 , 93 , 94 , 95 , 96 , 98 , 99 , 101 , 102 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 ]. Data are given as median and range, median and 95% confidence interval a , or median and interquartile range b .…”