title: Kinetics of the use of cryopreserved autologous stem cell grafts: a GITMO-SIDEM survey.
abstract: OBJECTIVE
  Hematopoietic stem cell cryopreservation significantly contributed to autologous stem cell transplantation (ASCT). Cryopreserved stem cell units (SCU) are expected to be used soon after harvesting for most purposes, but, in a number of cases, they remain stored for some time, creating an increasing load for SCU depositories. Disposal policies vary widely in each center, and the existing guidelines are insufficient.
  
  
  METHODS
  We conducted a survey of seven Gruppo Italiano Trapianto di Midollo Osseo centers to investigate the outcome of SCU harvested from January 2005 to December 2009 for ASCT. The data from 1603 collections were gathered, for a total of 5822 SCU.
  
  
  RESULTS
  In our cohort, 79% of patients collected >5 × 10⁶ CD34+ cells/kg, and 3.4% collected <2 × 10⁶ CD34+ cells/kg. Up to 21% of all the patients and 42% of those with acute leukemia did not undergo reinfusion, and 37% of the cryopreserved SCU were excess, resulting from patients not reinfusing or partially reinfusing. Less than one-third of the excess SCU was disposed, and the major causes of disposal were death and, in a minority of cases, withdrawal of the indication for ASCT. In our analysis, very few first reinfusions occurred after 2 years, and those after 5 years were exceptional. Through the use of a multivariate analysis, we sought to identify the risk factors for collection non-use, independent of the centers' policies. Non-use of SCU was significantly associated with patients with acute leukemia, collections of <2 × 10⁶ CD34/kg and lower age groups.
  
  
  CONCLUSIONS
  These data serve as a valid basis to support rational recommendations for cost-effective storage and disposal of SCU.
authors.affiliation: Hematology Clinic, Marche Polytechnic University, Ancona, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Olivieri
authors.affiliation: Immunohematology and Transfusion Unit, Azienda Ospedaliera San Camillo-Forlanini and Università di Roma-La Sapienza, Roma, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pierelli
authors.affiliation: The Hematology and Bone Marrow Transplant Units of Ospedali Riuniti di Bergamo, Bergamo, Italy.
authors.forename: Martino
authors.initials: M
authors.lastname: Introna
authors.affiliation: Immunohematology and Transfusion, Apheresis Unit, Azienda Ospedaliera Santo Spirito, Pescara, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Accorsi
authors.affiliation: Haematology Department, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
authors.affiliation: Transfusional Center, Apheresis and Criobiology Unit, San Gerardo Hospital, Monza, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Perseghin
authors.affiliation: Immunohematology and Transfusion Unit, IRCCS Giannina Gaslini, Genova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Risso
authors.affiliation: Immunohematology and Transfusion Unit, Azienda Ospedaliera San Camillo-Forlanini and Università di Roma-La Sapienza, Roma, Italy.
authors.forename: Annino
authors.initials: A
authors.lastname: Pandolfi
authors.affiliation: Hematology Clinic, Marche Polytechnic University, Ancona, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Mancini
authors.affiliation: Internal Medicine Unit, Cardinal Massaia Hospital, Asti, Italy.
authors.forename: Monia
authors.initials: M
authors.lastname: Marchetti
authors.affiliation: Haematology Department, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Dal Pozzo
authors.affiliation: The Hematology and Bone Marrow Transplant Units of Ospedali Riuniti di Bergamo, Bergamo, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Gotti
authors.affiliation: The Hematology and Bone Marrow Transplant Units of Ospedali Riuniti di Bergamo, Bergamo, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
authors.affiliation: Hematology Clinic, Marche Polytechnic University, Ancona, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Leoni
authors.affiliation: Hematology Clinic, Marche Polytechnic University, Ancona, Italy. Electronic address: a.olivieri@univpm.it.
authors.forename: Attilio
authors.initials: A
authors.lastname: Olivieri
mesh_terms: D064592:Autografts / Q000166:cytology / Q000378:metabolism; D064987:Cell- and Tissue-Based Therapy; D015925:Cryopreservation; D006412:Hematopoietic Stem Cells / Q000166:cytology* / Q000378:metabolism; D006801:Humans; D033581:Stem Cell Transplantation / Q000379:methods*
keywords: biological specimen banks; cryopreservation; hematopoietic progenitor cells; hematopoietic stem cell transplantation; long-term storage; medical waste disposal