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Hematopoietic Cell Transplantation with Cryopreserved Grafts for Severe Aplastic Anemia. Biol Blood Marrow Transplant 2020 07;26(7):e161-e166

Date

05/12/2020

Pubmed ID

32389803

Pubmed Central ID

PMC7206419

DOI

10.1016/j.bbmt.2020.04.027

Scopus ID

2-s2.0-85084668943   3 Citations

Abstract

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 MM

Authors

Saurabh Chhabra MD Associate Professor in the Medicine department at Medical College of Wisconsin
Anita D'Souza MD Associate Professor in the Medicine department at Medical College of Wisconsin
Mary 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 Center Director, 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 Assistant Professor in the Pediatrics department at Medical College of Wisconsin
J. Douglas D. Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Wael Saber MD, MS Associate Professor in the Medicine department at Medical College of Wisconsin
Bronwen E. Shaw MBChB, PhD 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 Disease
Adolescent
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
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a