Centro de Processamento Celular, Serviço de Hemoterapia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Serviço de Hematologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Transfusion. 2022 Oct;62(10):1967-1972. doi: 10.1111/trf.17090. Epub 2022 Sep 2.
Autologous stem cell transplantation is the standard procedure for multiple myeloma and the grafts are usually cryopreserved. Previous studies reported advantages in the use of fresh peripheral blood stem cells (PBSC) autotransplantation compared to cryopreservation of the grafts. This study compared the transplant-related outcomes of two graft preservation methods: fresh storage (4°C/72 h) and cryopreservation (-80°C).
We performed an analysis of 45 patients with multiple myeloma under autotransplantation (17 fresh and 28 cryopreserved) from 2017 to 2021. Fresh PBSC were maintained in the refrigerator for three days in a concentration up to 300 × 10 TNC/μL. Cryopreserved PBSC were concentrated by plasma reduction after centrifugation (950 g/10 min/4°C) and an equal volume of cryoprotection solution was added for a final concentration of 300 × 10 TNC/μL, 5% DMSO, 6% hydroxyethyl starch, and 3% human albumin.
Neutrophil engraftment was significantly faster with fresh PBSCs (10 vs. 11.5 days, p = 0.045). Adverse effects were more common in cryopreserved PBSC transplantation (75% vs. 35.3% patients; p = 0.013). Post transplantation hospital stay was 20 and 22 days for fresh and cryopreserved PBSCs respectively (p = 0.091). There was no difference in platelet engraftment time (10.5 days for both; p = 0.133), number of antibiotics used after transplantation (3 for fresh and 2.5 for cryopreserved; p = 0.828), days of antibiotic use after transplantation (12.2 days for fresh and 13.3 days for cryopreserved, p = 0.579), and overall survival (p = 0.736).
The infusion of fresh PBSC refrigerated for up to three days is effective and safe for autologous transplantation in patients with multiple myeloma, which is a useful alternative to cryopreserved PBSC.
自体干细胞移植是多发性骨髓瘤的标准治疗方法，移植物通常被冷冻保存。先前的研究报告称，与冷冻保存移植物相比，使用新鲜外周血造血干细胞（PBSC）自体移植具有优势。本研究比较了两种移植物保存方法的移植相关结果：新鲜保存（4°C/72 小时）和冷冻保存（-80°C）。
我们对 2017 年至 2021 年间进行自体移植的 45 例多发性骨髓瘤患者（新鲜组 17 例，冷冻组 28 例）进行了分析。新鲜 PBSC 在冰箱中保存三天，浓度最高可达 300×10 TNC/μL。冷冻 PBSC 在离心后（950g/10min/4°C）通过血浆减少浓缩，并加入等体积的冷冻保护液，最终浓度为 300×10 TNC/μL、5%DMSO、6%羟乙基淀粉和 3%人白蛋白。
新鲜 PBSC 的中性粒细胞植入明显更快（10 天对 11.5 天，p=0.045）。冷冻 PBSC 移植的不良反应更常见（75%对 35.3%的患者；p=0.013）。新鲜和冷冻 PBSC 移植后的住院时间分别为 20 天和 22 天（p=0.091）。血小板植入时间无差异（均为 10.5 天；p=0.133），移植后使用抗生素的数量（新鲜组 3 种，冷冻组 2.5 种；p=0.828），移植后使用抗生素的天数（新鲜组 12.2 天，冷冻组 13.3 天；p=0.579），以及总生存率（p=0.736）。
冷藏 3 天以内的新鲜 PBSC 输注对多发性骨髓瘤患者的自体移植是有效和安全的，是冷冻 PBSC 的有用替代方法。
