Hematopoietic Cell Transplantation with Cryopreserved Grafts for Severe Aplastic Anemia. Biol Blood Marrow Transplant 2020 Jul;26(7):e161-e166
Date
05/12/2020Pubmed ID
32389803Pubmed Central ID
PMC7206419DOI
10.1016/j.bbmt.2020.04.027Scopus ID
2-s2.0-85084668943 (requires institutional sign-in at Scopus site) 37 CitationsAbstract
With the COVID-19 pandemic and the ensuing barriers to the collection and transport of donor cells, it is often necessary to collect and cryopreserve grafts before initiation of transplantation conditioning. The effect on transplantation outcomes in nonmalignant disease is unknown. This analysis examined the effect of cryopreservation of related and unrelated donor grafts for transplantation for severe aplastic anemia in the United States during 2013 to 2019. Included are 52 recipients of cryopreserved grafts who were matched for age, donor type, and graft type to 194 recipients who received noncryopreserved grafts. Marginal Cox regression models were built to study the effect of cryopreservation and other risk factors associated with outcomes. We recorded higher 1-year rates of graft failure (hazard ratio [HR], 2.26; 95% confidence interval, 1.17 to 4.35; P = .01) and of 1-year overall mortality (HR, 3.13; 95% CI, 1.60 to 6.11; P = .0008) after transplantation of cryopreserved compared with noncryopreserved grafts, with adjustment for sex, performance score, comorbidity, cytomegalovirus serostatus, and ABO blood group match. The incidence of acute and chronic graft-versus-host disease did not differ between the 2 groups. Adjusted probabilities of 1-year survival were 73% (95% CI, 60% to 84%) in the cryopreserved graft group and 91% (95% CI, 86% to 94%) in the noncryopreserved graft group. These data support the use of noncryopreserved grafts whenever possible in patients with severe aplastic anemia.
Author List
Eapen M, Zhang MJ, Tang XY, Lee SJ, Fei MW, Wang HL, Hebert KM, Arora M, Chhabra S, Devine SM, Hamadani M, D'Souza A, Pasquini MC, Phelan R, Rizzo JD, Saber W, Shaw BE, Weisdorf DJ, Horowitz MMAuthors
Anita D'Souza MD Associate Professor in the Medicine department at Medical College of WisconsinMary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of Wisconsin
Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin
Rachel A. Phelan MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin
J. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Wael Saber MD, MS Professor in the Medicine department at Medical College of Wisconsin
Bronwen E. Shaw MBChB, PhD Center Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Acute DiseaseAdolescent
Adult
Aged
Anemia, Aplastic
Bone Marrow Transplantation
Child
Child, Preschool
Coronavirus Infections
Cryopreservation
Female
Graft Rejection
Graft vs Host Disease
Histocompatibility Testing
Humans
Male
Middle Aged
Pandemics
Peripheral Blood Stem Cell Transplantation
Pneumonia, Viral
Retrospective Studies
Siblings
Survival Analysis
Transplantation Conditioning
United States
Unrelated Donors