COVID-19 大流行期间，冷冻保存对造血干细胞植入和移植后结果的影响。
The Impact of Cryopreservation on Hematopoietic Stem Cell Engraftment and Post-transplant Outcome During the COVID-19 Pandemic.
机构信息
Faculty of Medicine in Katowice, Medical University of Silesia, Department of Hematology and Bone Marrow Transplantation, Katowice, Poland
Faculty of Medicine in Katowice, Medical University of Silesia, Department of Hematology and Bone Marrow Transplantation, Katowice, Poland.
出版信息
In Vivo. 2024 May-Jun;38(3):1271-1277. doi: 10.21873/invivo.13565.
BACKGROUND/AIM: The COVID-19 pandemic has had a significant impact on the current management of allotransplanted patients in whom fresh hematopoietic stem cells (HSCs) were replaced by cryopreserved ones. The aim of the study was to determine the efficacy and safety of cryopreserved HSCs when compared with the fresh ones.
PATIENTS AND METHODS
A retrospective analysis of 254 allogeneic stem cell transplantations (HSCT) procedures performed between 2020-2021 included the following donors: matched related (MRD; n=68), matched unrelated (MUD; n=148) and haploidentical (HID; n=38). 50% of patients (non-cryo group) received fresh grafts, whereas the remaining patients (cryo group) were transplanted with cryopreserved cells.
RESULTS
No differences in terms of median days to neutrophil [MRD/MUD/HID cryo- and non-cryo groups: 17 vs. 16 (p=0.27), 19 vs. 18 (p=0.83), 22 vs. 22 (p=0.83) days, respectively] and platelet [MRD/MUD/HID cryo- and non-cryo groups: 14 vs. 14 (p=0.25), 17 vs. 17 (p=0.33), 21 vs. 19 (p=0.36) days, respectively] engraftments were demonstrated. Among MUD graft recipients, platelet engraftment rates were 81% in the cryo- and 96% in the non-cryo group (p=0.01). OS rates were comparable at 1 year after HSCT between MRD/MUD/HID cryo- and non-cryo groups: 53% vs. 60% (p=0.54), 60% vs. 66% (p=0.5), 50% vs. 41% (p=0.56), respectively.
CONCLUSION
During the COVID-19 pandemic, cryopreserved HSCs did not have a negative impact on median engraftment time and OS when compared to fresh HSCs. In the MUD group, platelet engraftment rate was lower in cryopreserved HSC recipients.
背景/目的：COVID-19 大流行对目前接受异体移植的患者的管理产生了重大影响，这些患者的新鲜造血干细胞（HSCs）已被冷冻保存的 HSCs 所取代。本研究的目的是确定冷冻保存的 HSCs 的疗效和安全性，并与新鲜 HSCs 进行比较。
患者和方法
对 2020 年至 2021 年间进行的 254 例异基因干细胞移植（HSCT）手术进行回顾性分析，包括以下供体：匹配相关（MRD；n=68）、匹配无关（MUD；n=148）和单倍体（HID；n=38）。50%的患者（非冷冻组）接受新鲜移植物，其余患者（冷冻组）接受冷冻保存的细胞移植。
结果
中性粒细胞[MRD/MUD/HID 冷冻和非冷冻组的中位数天数：17 与 16（p=0.27）、19 与 18（p=0.83）、22 与 22（p=0.83）天]和血小板[MRD/MUD/HID 冷冻和非冷冻组的中位数天数：14 与 14（p=0.25）、17 与 17（p=0.33）、21 与 19（p=0.36）天]植入方面无差异。在 MUD 移植物受者中，冷冻组的血小板植入率为 81%，而非冷冻组为 96%（p=0.01）。MRD/MUD/HID 冷冻和非冷冻组在 HSCT 后 1 年的 OS 率相似：53%与 60%（p=0.54）、60%与 66%（p=0.5）、50%与 41%（p=0.56）。
结论
在 COVID-19 大流行期间，与新鲜 HSCs 相比，冷冻保存的 HSCs 对中位植入时间和 OS 没有负面影响。在 MUD 组中，冷冻保存 HSCs 受者的血小板植入率较低。
Zotero 插件