The Effect of Donor Graft Cryopreservation on Allogeneic Hematopoietic Cell Transplantation Outcomes: A Center for International Blood and Marrow Transplant Research Analysis. Implications during the COVID-19 Pandemic

Real-World Experience of Cryopreserved Allogeneic Hematopoietic Grafts during the COVID-19 Pandemic: A Single-Center Report

“…These data are consistent with the recently reported results from the largest retrospective study of the CIBMTR database. 7 However, in a multivariable analysis cryopreservation was not associated with statistically significant inferior OS or increased rate of GF. Given the small study size and the observed trend toward inferiority for the cryopreserved cohort, future studies with larger numbers of patients are warranted.…”

“…Our data are consistent with previous reports that raise concerns about a universal practice of cryopreservation for allo-HCT. 5 , 7 , 9 A strength of our study is that patients in both the cryopreserved and fresh cohort were consecutively collected, thereby minimizing selection bias. Moreover, patients who underwent cryopreserved allo-HCT were transplanted between March and August 2020 and represent our real-time experience during the COVID-19 pandemic.…”

“…Since the institution of pandemic restrictions, the Center for International Blood and Marrow Transplant Research (CIBMTR) has reported on three retrospective studies the clinical outcomes of cryopreserved as compared to fresh allogeneic donor products. 5 , 6 , 7 The study by Eapen and colleagues 5 , which focused on patients with severe aplastic anemia, showed higher rates of GF and inferior OS with cryopreserved allografts. Whereas the study by Hamadani and colleagues which included only patients undergoing allo-HCT with post-transplantation cyclophosphamide (ptCy) as GVHD prophylaxis 6 , showed similar outcomes for cryopreserved as compared to fresh allografts.…”

“…Whereas the study by Hamadani and colleagues which included only patients undergoing allo-HCT with post-transplantation cyclophosphamide (ptCy) as GVHD prophylaxis 6 , showed similar outcomes for cryopreserved as compared to fresh allografts. The more recent and largest study by Hsu and colleagues 7 examined a total of 7379 patients from the CIBMTR database transplanted between 2013 and 2018, and separately assessed the impact of cryopreservation on clinical outcomes for (1) URD PBSC grafts, (2) related PBSC grafts and (3) bone marrow (BM) grafts. This study demonstrated clear inferiority of cryopreserved URD PBSC grafts with delayed hematopoietic recovery, increased NRM and relapse and decreased progression free survival (PFS) and OS.…”

A Timely CIBMTR Analysis of How Cryopreservation Impacts Allogeneic Hematopoietic Cell Transplantation to Apply in the COVID Era

“…Prior studies of cryopreservation have been limited by small numbers and bias regarding the reason for cryopreservation, although collectively, appear to show no significant impact on time to initial engraftment, GVHD, relapse, or survival 2 . In the report by Hsu et al in this issue of TCT 3 , the authors analyzed the impact of cryopreservation on 1883 patients who received cryopreserved marrow, related PBSC or unrelated PBSCs with 5514 matched controls. This is by far the largest study addressing this issue and a clear strength of this analysis using data from the CIMBTR registry is their ability to identify large well-matched control groups for comparison.…”