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Non-cryopreserved autologous peripheral blood stem cell transplantation for multiple myeloma and lymphoma in countries with limited resources: practice considerations from the Worldwide Network for Blood and Marrow Transplantation.
Bone Marrow Transplant
January 2025
Adult Hematology, Stem Cell Transplant & Cellular Therapy, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Article Synopsis
- Autologous peripheral blood stem cell (PBSC) transplantation is a common treatment for conditions like multiple myeloma and lymphomas, and it usually involves freezing the stem cells before transplant.* -
- A recent systematic review of 19 transplant centers that performed non-cryopreserved PBSC transplants showed that the procedure is feasible and safe, with high stem cell viability and low rates of complications.* -
- The study found that stem cell viability was over 90% for multiple myeloma and over 75% for lymphomas, with quick engraftment times, and only 1% transplant-related mortality within 100 days.*
Post-thaw CD34+ cell recovery likely degraded under extreme graft platelet concentrations.
Bone Marrow Transplant
December 2024
New Zealand Blood Service, 15 Lester Lane, Christchurch, New Zealand.
Article Synopsis
- The study investigates the relationship between platelet concentration and the viability of post-thaw CD34 cells in autologous hematopoietic stem cell transplants, suggesting that lower postCD34 viability may lead to delayed engraftment.
- A significant negative correlation between platelet concentration and postCD34 recovery was found, particularly in patients with platelet counts between 1500-2000 ×10/L.
- The data indicates that both low and high platelet concentrations negatively impact postCD34 recovery, with specific subsets of patients exhibiting these trends based on their type of lymphoma or myeloma.
Identifying Candidates for Effective Utilization of Stored Autologous PBSCs in Salvage Transplantation for Multiple Myeloma: Who Benefits Most?
Hematol Rep
July 2024
Division of Hematology and Oncology, Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA.
High-dose chemotherapy (HD-CHT) followed by autologous stem cell transplantation (ASCT) remains the gold standard for eligible multiple myeloma (MM) patients, even amidst evolving therapeutic options. Clinical trials have demonstrated ASCT's efficacy in MM, including its potential as salvage therapy after prolonged remission. Peripheral blood stem cells (PBSCs) are now the primary source of hematopoietic stem cells for ASCT.
View Article and Find Full Text PDF[Retrospective clinical study on cryopreservation-free integrated autologous hematopoietic stem cell transplantation model for newly diagnosed multiple myeloma].
Zhonghua Xue Ye Xue Za Zhi
May 2024
Department of Hematology, Sichuan Provincial Peoples Hospital, Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu 610071, China.
To explore the efficacy and safety of cryopreservation-free integrated autologous hematopoietic stem cell transplantation (HSCT) model for patients with multiple myeloma. A total of 96 patients with newly diagnosed multiple myeloma (NDMM) between July 31, 2020, and December 31, 2022, were retrospectively analyzed, of which 41 patients in the observation group received integrated non-cryopreserved transplantation mode. After hematopoietic stem cells were mobilized and collected, melphalan was started immediately for pre-transplant conditioning, and non-cryopreserved grafts from the medical blood transfusion refrigerator were directly injected intravenously into the patient within 24-48 h after the melphalan conditioning.
View Article and Find Full Text PDFClonal Hematopoiesis is Associated With Severe Cytokine Release Syndrome in Patients Treated With Chimeric Antigen Receptor T-Cell (CART) Therapy.
Transplant Cell Ther
September 2024
Department of Population Sciences Program, City of Hope Comprehensive Cancer Center, Duarte, California; Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, California.
Among patients receiving CD19 or B-cell maturation antigen (BCMA) CAR T therapy, inflammation pre- and post-CAR T infusion is implicated in the development of toxicities including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and likely contributes to prolonged cytopenias. Clonal hematopoiesis (CH), the clonal expansion of hematopoietic stem cells harboring somatic mutations, has been associated with inflammasome upregulation. Herein, we examined the prevalence of pre-CAR T CH in a predominantly transplant-naïve cohort of recipients with non-Hodgkin lymphoma (NHL) or multiple myeloma (MM), and assessed the relationship between the presence of CH mutations and CAR T-related outcomes including CRS, ICANS, prolonged cytopenia, progression-free survival (PFS), and overall survival (OS).
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