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Allografting

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

Bone Marrow Transplantation volume 48, pages 243–248 (2013)Cite this article

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Abstract

Cryopreservation of PBSC for allo-SCT offers potential advantages; however, its impact on engraftment and outcomes remains unclear. A total of 76 allo-SCT performed using cryopreserved PBSC from HLA identical related (n=57) and unrelated donors (n=19) were compared with 123 fresh PBSC allo-SCT. Median neutrophil engraftment was on day 12 for both cryopreserved and fresh PBSC; in multivariate analysis, there was a slight but significant delay in neutrophil engraftment after the median date (hazard ratio (HR)=1.44, P=0.003). Platelet engraftment was significantly delayed in cryopreserved PBSC recipients (median time 19 vs 14 days). In multivariate analysis cryopreservation (HR=1.85, P<0.001), earlier date of transplant and lower CD34+ cell dose were associated with delayed platelet engraftment. Two-year OS and relapse and 1-year TRM rates did not differ significantly. Acute GVHD incidence was comparable, and extensive chronic GVHD at 1 year was higher in cryopreserved PBSC recipients (40.3 vs 28.3%), but not significantly so (P=0.13). Cryopreservation of related and unrelated donor allogeneic PBSC is safe and effective where its benefits outweigh the risks of delayed platelet engraftment; its impact on chronic GVHD incidence requires further assessment.

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Acknowledgements

We thank Janice Ward for assistance with the data collection.

Author contributions: PM contributed to the study design, collected and analysed the data and wrote the manuscript; SN contributed to the study design and collected the data; DH contributed to the study design, performed cryopreservation and collected the data; CC designed the study and critically reviewed the manuscript; RM designed the study and critically reviewed the manuscript.

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Authors and Affiliations

  1. Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK

    P Medd, S Nagra, C Craddock & R Malladi

  2. Cancer and Haematology Centre, Churchill Hospital, Oxford, UK

    P Medd

  3. NHS Blood and Transplant, Birmingham Centre, Birmingham, UK

    D Hollyman

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  1. P Medd
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  2. S Nagra
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Correspondence to R Malladi.

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Medd, P., Nagra, S., Hollyman, D. et al. Cryopreservation of allogeneic PBSC from related and unrelated donors is associated with delayed platelet engraftment but has no impact on survival. Bone Marrow Transplant 48, 243–248 (2013). https://doi.org/10.1038/bmt.2012.118

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