Impact of cryopreservation and transit times of allogeneic grafts on hematopoietic and immune reconstitution.
Katie Maurer, Haesook T Kim, Thomas M Kuczmarski, Heather M Garrity, Augustine Weber, Carol G Reynolds, Deborah Liney, Corey Cutler, Joseph H Antin, John Koreth, Jerome Ritz, Roman M Shapiro, Rizwan Romee, Catherine J Wu, Robert J Soiffer, Sarah Nikiforow, Vincent T Ho, Mahasweta Gooptu
Author Information
Katie Maurer: Department of Medical Oncology and. ORCID
Haesook T Kim: Department of Data Science, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; and.
Thomas M Kuczmarski: Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Heather M Garrity: Department of Medical Oncology and.
Augustine Weber: Department of Medical Oncology and.
Carol G Reynolds: Department of Medical Oncology and.
Deborah Liney: Department of Medical Oncology and.
Corey Cutler: Department of Medical Oncology and. ORCID
Joseph H Antin: Department of Medical Oncology and.
John Koreth: Department of Medical Oncology and.
Jerome Ritz: Department of Medical Oncology and. ORCID
Roman M Shapiro: Department of Medical Oncology and.
Rizwan Romee: Department of Medical Oncology and.
Catherine J Wu: Department of Medical Oncology and. ORCID
Robert J Soiffer: Department of Medical Oncology and.
Sarah Nikiforow: Department of Medical Oncology and.
Vincent T Ho: Department of Medical Oncology and.
Mahasweta Gooptu: Department of Medical Oncology and.
We sought to evaluate the impact of cryopreservation of unrelated donor (URD) peripheral blood stem cell (PBSC) grafts on engraftment, chimerism, and immune reconstitution in the context of the COVID-19 pandemic. We reviewed stem cell product characteristics and clinical outcomes in 101 patients receiving cryopreserved PBSCs from URDs between January 1, 2019 and 31 December, 2020, compared with 203 patients receiving fresh URD PBSCs. We observed no differences in 6-month overall survival, progression-free survival, or nonrelapse mortality. patients receiving cryopreserved PBSCs had delayed platelet engraftment and impaired reconstitution of white blood cells and T-cell subsets at day 30. Thirty-four percent of patients receiving cryopreserved grafts had CD3 chimerism <50% at day 30 after transplantation, compared with 14% of patients receiving fresh PBSCs (P = .0002). At day 100, this difference persisted (CD3+ chimerism <50%: 17% of cryopreserved cohort vs 6% of fresh cohort; P = .016). Greater product age at infusion was associated with increased graft failure, independent of cryopreservation. Receipt of grafts >48 hours old at time of cryopreservation or infusion significantly increased the risk of graft failure (subdistribution hazard ratio = 4.57; 95% confidence interval, 1.71-12.3; P = .0025). Our data indicate that cryopreservation is associated with similar overall short-term clinical outcomes compared with fresh PBSC. However, patients must be monitored closely for increased risk of other potentially adverse outcomes, including graft failure and poor immune recovery, particularly for grafts with older overall age at infusion. Longer-term follow-up is needed to determine impact on relapse and survival.
