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Cryopreserved versus non-cryopreserved peripheral blood stem cells for autologous transplantation after high-dose Melphalan in multiple myeloma: comparative analysis

Bone Marrow Transplantation volume 54, pages 138–141 (2019)Cite this article

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Multiple myeloma (MM) is the most frequent indication for autologous stem cell transplantation (ASCT) [1]. Melphalan 200 mg/m2 is the gold standard conditioning regimen and peripheral blood stem cells (PBSC) is the major source of cells [1, 2]. Conventionally, PBSC are cryopreserved after harvesting (CRYO), allowing time for recovery from chemo-mobilization or administration of further cycles of chemotherapy, if needed [2]. Dimethyl sulfoxide (DMSO), a cryoprotectant, is used to prevent freezing damage to living cells [2, 3]. Although generally safe, DMSO can be associated with mild adverse reactions and more severe effects, such as cardiovascular, neurological, respiratory, renal, and hepatic disfunction [3]. Cryopreservation requires expensive equipment and trained personnel, which may not be available in developing countries [2, 4,5,6]. Storage of PBSC in its natural liquid state is not standard practice, but previous studies showed ASCT can be safely performed using non-cryopreserved PBSC (non-CRYO) [2, 4,5,6]. The American Association of Blood Bank asserts stem cells remain viable up to 3–5 days when stored in liquid state in blood bank refrigerators at 1–6 °C [7]. Short-term storage of non-CRYO is feasible and cost-saving [2, 4,5,6]. We herein reported our experience on ASCT for MM using both methods of storage and compared outcomes and costs.

We retrospectively analyzed charts of all patients with MM who underwent ASCT at Hospital das Clinicas da Universidade de Sao Paulo between January of 2014 and October of 2016, excluding the period between January and July of 2015, due to internal issues in the stem cell laboratory. In August of 2015, we started to perform ASCT using non-CRYO. After the good results, it became our method of choice; CRYO was then reserved for selected cases (delay due to clinical condition or logistic matters). Follow-up was carried for 30 days post-ASCT.

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Acknowledgements

We thank the stem cell laboratory at Hospital das Clinicas de Sao Paulo for providing relevant data. This study was presented in abstract form at the XXI annual meeting of the Brazilian Society of Bone Marrow Transplantation, in Sao Paulo-SP, Brazil, 17-19 of August, 2017.

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Authors and Affiliations

  1. Service of Hematology, Transfusion and Cell Therapy, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil

    M. C. B. Bittencourt, L. Mariano, F. Moreira, J. Schmidt-Filho, A. Mendrone-Jr & V. Rocha

  2. Pro-Sangue Foundation Blood Donation Center, Sao Paulo, Brazil

    A. Mendrone-Jr & V. Rocha

  3. Department of Hematology, Churchill Hospital, NHSBT, University of Oxford, Oxford, UK

    V. Rocha

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  1. M. C. B. Bittencourt
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Correspondence to V. Rocha.

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Bittencourt, M.C.B., Mariano, L., Moreira, F. et al. Cryopreserved versus non-cryopreserved peripheral blood stem cells for autologous transplantation after high-dose Melphalan in multiple myeloma: comparative analysis. Bone Marrow Transplant 54, 138–141 (2019). https://doi.org/10.1038/s41409-018-0250-1

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