Clinical Impact of Graft Cryopreservation on Allogeneic Stem Cell Transplantation: An Italian, Registry-Based Study on Behalf of the “Gruppo Italiano Per Il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare” (GITMO)
Irene Defrancesco, Virginia Valeria Ferretti, Patrizia Chiusolo, Domenico Russo, Chiara Nozzoli, Attilio Olivieri, Massimiliano Gambella, Irene Maria Cavattoni, Stefania Bramanti, Stella Santarone, Renato Fanin, Roberto Cairoli, Simona Piemontese, Matteo Parma, Francesco Onida, Alessandro Busca, Luca Castagna, Angela Cuoghi, Domenico Pastore, Nicola Mordini, Fabio Benedetti, Cristina Skert, Carlo Borghero, Anna Paola Iori, Franca Fagioli, Vincenzo Pavone, Carmine Selleri, Simone Cesaro, Maurizio Musso, Marco Ladetto, Daniele Vallisa, Paola Carluccio, Alessandra Picardi, Monica Tozzi, Alessandra Biffi, Giuseppe Milone, Maura Faraci, Arcangelo Prete, Lucia Prezioso, Antonio Maria Risitano, Francesco Paolo Tambaro, Veronica Tintori, Piero Galieni, Fabrizio Pane, Caterina Zerbi, Antonio Bianchessi, Giulia Losi, Francesco Romano, Alessia Taurino, Elena Oldani, Nicola Polverelli, Francesca Bonifazi, Massimo Martino
{"title":"Clinical Impact of Graft Cryopreservation on Allogeneic Stem Cell Transplantation: An Italian, Registry-Based Study on Behalf of the “Gruppo Italiano Per Il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare” (GITMO)","authors":"Irene Defrancesco, Virginia Valeria Ferretti, Patrizia Chiusolo, Domenico Russo, Chiara Nozzoli, Attilio Olivieri, Massimiliano Gambella, Irene Maria Cavattoni, Stefania Bramanti, Stella Santarone, Renato Fanin, Roberto Cairoli, Simona Piemontese, Matteo Parma, Francesco Onida, Alessandro Busca, Luca Castagna, Angela Cuoghi, Domenico Pastore, Nicola Mordini, Fabio Benedetti, Cristina Skert, Carlo Borghero, Anna Paola Iori, Franca Fagioli, Vincenzo Pavone, Carmine Selleri, Simone Cesaro, Maurizio Musso, Marco Ladetto, Daniele Vallisa, Paola Carluccio, Alessandra Picardi, Monica Tozzi, Alessandra Biffi, Giuseppe Milone, Maura Faraci, Arcangelo Prete, Lucia Prezioso, Antonio Maria Risitano, Francesco Paolo Tambaro, Veronica Tintori, Piero Galieni, Fabrizio Pane, Caterina Zerbi, Antonio Bianchessi, Giulia Losi, Francesco Romano, Alessia Taurino, Elena Oldani, Nicola Polverelli, Francesca Bonifazi, Massimo Martino","doi":"10.1002/ajh.27731","DOIUrl":null,"url":null,"abstract":"<p>The coronavirus disease 2019 (COVID-19) pandemic created major challenges for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Scientific societies and authorities recommended cryopreserving grafts before starting conditioning regimens, despite limited data on the clinical impact. The Italian Group for Bone Marrow Transplantation (GITMO) conducted a registry-based study involving 3492 patients who underwent allo-HSCT between March 2018 and September 2021. The cryopreserved cohort (<i>n</i> = 976) included patients who received cryopreserved grafts during the pandemic and was compared to the historical cohort (<i>n</i> = 2516). Graft cryopreservation was associated with a lower day 30 incidence of neutrophil and platelet engraftment (adjusted sHR = 0.8 and 0.7, <i>p</i> = 0.031 and <i>p</i> < 0.001, respectively) and delayed hematopoietic recovery. However, primary graft failure rates at day +30 were similar in the cryo and historical cohort (4% vs. 5%, respectively; <i>p</i> = 0.337), also after adjustment (RR = 1.19, <i>p</i> = 0.518). Day 100 incidence of grade II-IV acute GVHD was comparable between the two groups (adjusted sHR = 1.2, <i>p</i> = 0.194). Regarding chronic GVHD incidence, we found that it was higher in patients aged < 18 years in the cryo group (adjusted sHR = 3.9, <i>p</i> = 0.002), but lower in those aged 18–55 years (adjusted sHR = 0.7, <i>p</i> = 0.008). Cumulative incidence of relapse did not differ between historical and cryo cohort (adjusted sHR 1.0. <i>p</i> = 0.943), as well as non-relapse mortality (adjusted sHR 1.1, <i>p</i> = 0.196) and relapse-free survival (adjusted sHR = 1.1, <i>p</i> = 0.197). However, a shorter overall survival was observed in the cryopreserved group (adjusted HR = 1.2, <i>p</i> = 0.038). Transplant centers should carefully balance the benefits and drawbacks of cryopreservation in allo-HSCT.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"100 8","pages":"1354-1364"},"PeriodicalIF":10.1000,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27731","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Hematology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ajh.27731","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
The coronavirus disease 2019 (COVID-19) pandemic created major challenges for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Scientific societies and authorities recommended cryopreserving grafts before starting conditioning regimens, despite limited data on the clinical impact. The Italian Group for Bone Marrow Transplantation (GITMO) conducted a registry-based study involving 3492 patients who underwent allo-HSCT between March 2018 and September 2021. The cryopreserved cohort (n = 976) included patients who received cryopreserved grafts during the pandemic and was compared to the historical cohort (n = 2516). Graft cryopreservation was associated with a lower day 30 incidence of neutrophil and platelet engraftment (adjusted sHR = 0.8 and 0.7, p = 0.031 and p < 0.001, respectively) and delayed hematopoietic recovery. However, primary graft failure rates at day +30 were similar in the cryo and historical cohort (4% vs. 5%, respectively; p = 0.337), also after adjustment (RR = 1.19, p = 0.518). Day 100 incidence of grade II-IV acute GVHD was comparable between the two groups (adjusted sHR = 1.2, p = 0.194). Regarding chronic GVHD incidence, we found that it was higher in patients aged < 18 years in the cryo group (adjusted sHR = 3.9, p = 0.002), but lower in those aged 18–55 years (adjusted sHR = 0.7, p = 0.008). Cumulative incidence of relapse did not differ between historical and cryo cohort (adjusted sHR 1.0. p = 0.943), as well as non-relapse mortality (adjusted sHR 1.1, p = 0.196) and relapse-free survival (adjusted sHR = 1.1, p = 0.197). However, a shorter overall survival was observed in the cryopreserved group (adjusted HR = 1.2, p = 0.038). Transplant centers should carefully balance the benefits and drawbacks of cryopreservation in allo-HSCT.
期刊介绍：
The American Journal of Hematology offers extensive coverage of experimental and clinical aspects of blood diseases in humans and animal models. The journal publishes original contributions in both non-malignant and malignant hematological diseases, encompassing clinical and basic studies in areas such as hemostasis, thrombosis, immunology, blood banking, and stem cell biology. Clinical translational reports highlighting innovative therapeutic approaches for the diagnosis and treatment of hematological diseases are actively encouraged.The American Journal of Hematology features regular original laboratory and clinical research articles, brief research reports, critical reviews, images in hematology, as well as letters and correspondence.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
