Clinical impact of cryopreservation of allogeneic hematopoietic cell grafts during the onset of the COVID-19 pandemic. Blood Adv 2023 Oct 10;7(19):5982-5993
Date
04/11/2023Pubmed ID
37036959Pubmed Central ID
PMC10580174DOI
10.1182/bloodadvances.2023009786Scopus ID
2-s2.0-85172442056 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
At the onset of the COVID-19 pandemic, the National Marrow Donor Program mandated the cryopreservation of hematopoietic cell grafts from volunteer unrelated donors because of numerous patient and donor safety concerns and logistical hurdles. Using the Center for International Blood and Marrow Transplant Research outcomes database, we report the impact of cryopreservation on overall survival (OS) and other outcomes within 1 year after hematopoietic cell transplantation (HCT). We analyzed 1543 recipients of cryopreserved allografts receiving HCT at US centers during the first 6 months of the pandemic and compared them with 2499 recipients of fresh allografts during a 6-month period in 2019. On multivariable regression analysis, we observed no difference in the OS (P = .09), nonrelapse mortality (P = .89), graft-versus-host disease (GVHD), or GVHD- and relapse-free survival (P = .58) in recipients of cryopreserved vs fresh allografts. Disease-free survival (DFS) was lower in the cryopreserved allograft recipients (P = .006) because of a higher risk of relapse (P = .01) compared with the fresh allograft recipients. Primary graft failure was higher (P = .01), and the risk of chronic GVHD was lower (P = .001) with cryopreservation compared with fresh grafts. In conclusion, although there was no negative impact of cryopreservation on OS, relapse was higher, and DFS was lower than that with no cryopreservation. Fresh grafts are recommended as the pandemic-related logistical hurdles resolve. Cryopreservation should be considered an option for patients when fresh grafts are not feasible.
Author List
Devine SM, Bo-Subait S, Kuxhausen M, Spellman SR, Bupp C, Ahn KW, Stefanski HE, Auletta JJ, Logan BR, Shaw BEAuthors
Kwang Woo Ahn PhD Professor in the Institute for Health and Equity department at Medical College of WisconsinBrent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Bronwen E. Shaw MBChB, PhD Center Director, Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
CryopreservationGraft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Pandemics
Recurrence
Unrelated Donors
