Hematologic, immunologic reconstitution, and outcome of 342 autologous peripheral blood stem cell transplantations after cryopreservation in a -80°C mechanical freezer and preserved less than 6 months.
BACKGROUND
Controlled-rate freezing and storage in nitrogen is the standard technique for cryopreservation of peripheral hematopoietic progenitor cells (PHPCs) but presents high cost and dimethyl sulfoxide (DMSO) toxicity. Cryopreservation at -80°C, by uncontrolled rate freezing with only 3.5% DMSO, preserves the functional capacities of PHPCs, produces successful engraftment, and reduces toxicity during infusion.


METHODS
Long-term hematopoietic and immunologic reconstitution for 342 autografts (311 adults, 31 children) after PHPCs were cryopreserved at -80°C was studied at 3, 6, and 12 months. The median (range) storage time of PHPCs cryopreserved was 1.7 (0.1-5.99) months.


RESULTS
Hemoglobin (Hb), white blood cells, and platelets (PLTs) reach normal values to trilineage at 12 months for 39% patients. Multivariate analysis shows a significant impact on CD34+ infused and on conditioning regimen for PLTs. Hb was influenced by growth factor administration at 3 months. Long-term recovery is also highly dependent on blood counts (Hb, PLT, and neutrophil) at start of high-dose chemotherapy. Only 43% of patients had reached normal lymphocyte values at 12 months after transplant, and a profound CD4+ T-lymphocyte deficit remained, as others reported.


CONCLUSIONS
Transplantation with PHPCs cryopreserved at -80°C for no more than 6 months is satisfactory for long-term hematopoietic and immunologic reconstitution, even if a profound CD4+ T lymphocyte deficit persists at 1 year. This easier and cheaper cryopreservation method also leads to successful engraftment.
Department of Clinical Hematology and Cell Therapy, EA3846, CIC 501, Auvergne University, France.
Laure
L
Calvet
Aurélie
A
Cabrespine
Nathalie
N
Boiret-Dupré
Etienne
E
Merlin
Catherine
C
Paillard
Marc
M
Berger
Jacques-Olivier
JO
Bay
Olivier
O
Tournilhac
Pascale
P
Halle
D000293:Adolescent; D000328:Adult; D000368:Aged; D001793:Blood Preservation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015925:Cryopreservation / Q000379:methods; D005260:Female; D005615:Freezing / Q000009:adverse effects; D006085:Graft Survival; D006410:Hematopoiesis / Q000502:physiology*; D006412:Hematopoietic Stem Cells / Q000502:physiology; D006801:Humans; D007109:Immunity / Q000502:physiology*; D007223:Infant; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult