背景:外周血干细胞(PBSC)自体移植是符合移植条件的多发性骨髓瘤(MM)患者的标准治疗方法。由于经济资源的高消耗和使用Cryobank的机会,这种治疗选择在一定程度上受到限制。
目的:比较使用非冷冻保存和冷冻保存的造血干细胞(HSC)进行自体移植的结果。
方法:2018-2022年进行的单中心回顾性研究。
方法:78例MM患者纳入研究。所有患者均接受了标准的免疫化疗方案,并有所缓解。患者分为两组:非CRYO(n=35)和CRYO(n=43)。冷冻保存是HSC储存的标准方法。将天然HSC从+4°C保存至+6°C达72小时。CD34+和7AAD-细胞的数量,在单采后和移植前进行集落形成能力。
方法:使用非冷冻保存和冷冻保存的HSC进行自体移植的结果。
结果:CD34+细胞总数x106/kg没有差异,或者在7AAD-细胞的水平上,或完全殖民地。从单采时到再输注时,CD34细胞的损失百分比存在显着差异。我们认为这是由CRYO组温度变化的不利影响引起的。非CRYO组的中性粒细胞恢复在第11天(范围9-14),血小板恢复在第12天(范围8-19),CRYO组的第10天(范围8-14)和第12天(范围8-20),分别。在autoHSCT之前的部分反应达到了37%,非常好的部分反应——40%,完全反应-非CRYO组23%和72%,14%,在CRYO组中14%,分别。23%的患者在自体造血干细胞移植后获得部分缓解,40%的部分反应非常好,与CRYO组相比,非CRYO组的完全缓解率为37%(47%,21%,32%,分别)。autoHSCT前MRD阴性反应的频率为37.5%,移植后-非CRYO组为54.5%,CRYO组为16%和33%。
结论:无需冷冻保存的PBSCs的保存方法与传统的控制冷冻方法相同,可以在没有冷冻库的医院中使用。
BACKGROUND: Peripheral blood stem cells (PBSCs) autologous transplantation is the standard care for transplant-eligible patients with multiple myeloma (MM). This treatment option is somewhat limited due to the high consumption of economic resources and the access to Cryobank.
OBJECTIVE: Compare the results of autologous transplantation using non-cryopreserved and cryopreserved hematopoietic stem cells (HSC).
METHODS: Single center retrospective study conducted in 2018-2022.
METHODS: 78 patients with MM were included in the study. All patients got the standard immunochemotherapy programs and had remission. Patients were divided into two groups: non-CRYO (n=35) and CRYO (n=43). Cryopreservation is a standard method of storage of HSC. Native HSC are saved from +4 °C to +6 °C for 72 hours. The number of CD34+ and 7AAD- cells, colony-forming ability were made after apheresis and before transplantation.
METHODS: The results of autologous transplantation with use non-cryopreserved and cryopreserved HSC.
RESULTS: There were no differences in total number of CD34+ cells x106/kg, or in level of 7AAD- cells, or in total colony. There was a significant difference in the percentage of loss of CD34+ cells from the moment of apheresis to the moment of reinfusion. We suppose it was caused by adverse effects of temperature changes in CRYO group. Neutrophil recovery was achieved at 11th day (range 9-14) and platelets at 12th day (range 8-19) in non-CRYO group, 10th day (range 8-14) and 12th day (range 8-20) in CRYO group, respectively. The partial response before autoHSCT was achieved in 37%, very good partial response-40%, complete response - 23% in the non-CRYO group and 72%, 14%, 14% in the CRYO group, respectively. Partial response after autoHSCT was achieved in 23% patients, very good partial response in 40%, complete response in 37% in the non-CRYO group compared to the CRYO group (47%, 21%, 32%, respectively). The frequency of MRD-negative response before autoHSCT was 37.5%, after transplantation - 54.5% in the non-CRYO group and 16% and 33% in the CRYO group.
CONCLUSIONS: The method of storage of PBSCs without cryopreservation is equal to traditional method controlled freezing and can be used in hospitals which have no Cryobank.