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Automated washing of autologous hematopoietic stem cell grafts after thawing does not impair engraftment

Bone Marrow Transplantation volume 49, pages 1127–1128 (2014)Cite this article

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Autologous hematopoietic SCT (AHSCT) remains widely used to support the administration of high-dose chemotherapy to a subset of patients affected by malignant blood diseases, mostly lymphoid malignancies. Nowadays, patients are almost exclusively transplanted with peripheral blood grafts, collected by apheresis, after mobilization of hematopoietic progenitor with various regimens. Cryopreservation and storage of collected cell products in liquid- or gas-phase nitrogen are mandatory before reinfusion. The historical but still topical technique of cryopreservation uses DMSO as cryoprotectant in order to prevent intracellular ice crystal formation, thus preserving cell viability and function. Reinfusion of the graft thawed at the bedside might be associated with various side effects,1 ranging from mild to severe. The etiology of these adverse effects is generally attributed to DMSO, damaged cells or cell lysis products. In order to remove such byproducts, biomedical devices like Cytomate (Baxter, Deerfield, IL, USA) or Sepax (Biosafe, Eysins, Switzerland) have been developed for washing thawed grafts before reinfusion. Additionally, cell therapy facilities are under increasing regulatory pressure to better characterize and control the cell product to be reinfused, which can only be done to a limited extent when thawing at the bedside.

However, washing thawed grafts before infusion remains controversial2 since CD34+ progenitor cell loss is unavoidable and might induce delayed engraftment.3 This is in opposition to the process of bedside thawing followed by direct infusion, where cell loss is supposed to be lower but remains unknown due to the absence of quality control on the thawed graft. This controversy therefore remains hypothetical, as there is, to our knowledge, no matched analysis comparing the end point of both procedures, that is, hematopoietic reconstitution. In order to determine if cell loss associated with the washing step has a detrimental effect on engraftment, we retrospectively compare two cohorts of carefully matched patients, who received either washed or unwashed autologous grafts.

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Acknowledgements

We thank Frederick Christy at the Département de la Recherche Clinique et de l'Innovation, Institut Paoli-Calmettes, for data management, and the staff of the Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, for careful management of cell products.

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Author notes

  1. B Calmels and A Drezet: These authors contributed equally to this work.

Authors and Affiliations

  1. Département de Biologie du Cancer, Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France

    B Calmels, C Huynh, C Malenfant, C Lemarié & C Chabannon

  2. Inserm CBT-510, Centre d’Investigations Cliniques en Biothérapie, Marseille, France

    B Calmels, C Lemarié & C Chabannon

  3. Inserm UMR 1068, CNRS UMR 7258, AMU 105, Centre de Recherche en Cancérologie de Marseille, Marseille, France

    B Calmels, A Drezet & C Chabannon

  4. Département de la Recherche Clinique et de l’Innovation (DRCI), Unité de Biostatistique et de Méthodologie, Institut Paoli-Calmettes, Marseille, France

    A Autret

  5. Département d’Onco-Hématologie, Institut Paoli-Calmettes, Marseille, France

    A-M Stoppa, R Bouabdallah & D Coso

  6. Aix-Marseille Université (AMU), Marseille, France

    C Chabannon

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  1. B Calmels
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  2. A Drezet
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Correspondence to B Calmels.

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Calmels, B., Drezet, A., Huynh, C. et al. Automated washing of autologous hematopoietic stem cell grafts after thawing does not impair engraftment. Bone Marrow Transplant 49, 1127–1128 (2014). https://doi.org/10.1038/bmt.2014.111

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