Short-term cryopreserved allogeneic stem cells to optimize graft and recipient conditions in children

Ref ID: 18593

Author:

P. Sovinz, W. Schwinger, H. Lackner, M. Benesch, A. Nebl,
A. Raicht, S. Sipurzynski, K. Rosskopf, C. Urban

Author address:

Medical University of Graz (Graz, AT)

Full conference title:

Annual Meeting of the EBMT, 36th

Abstract:

Background: Stem cell grafts intended for allogeneic hematopoietic stem cell transplantation are usually collected and
transfused “œfresh”. Data regarding the use of cryopreserved
allografts are scarce and limited to adults.
Patients and methods: We report on 4 pediatric patients aged
2.6, 1.75, 15.9 and 11.3 years, respectively (m:f = 1:3) suffering from relapsed acute myelogenous leukemia FAB M5,
Mucopolysaccharidosis I Hurler, severe aplastic anemia and
metastatic osteosarcoma, respectively, in whom conditioning
had to be unexpectedly postponed at short notice for medical reasons (infections n = 3; non-remission n = 1). Stem cell
donors (unrelated n = 3, HLA match: 10/12, 11/12, 12/12; haploidentical related n = 1) gave their consent to short time stem
cell cryopreservation and graft manipulation. Stem cell grafts
were manipulated (CD3/19 depletion: n = 4; additional CD34 + S273
selection: n = 2) and cryopreserved for 6, 13, 11 and 102 days,
respectively. After conditioning with busulfan/ treosulfan-based
(n = 2) or fl udarabine-based (n = 2) regimens patients received
10.55, 20.3, 12.9 and 15.37 x 10
6
CD34 + cells/kg together with
3.27 x 10
8
, 1.2, 0.55 and 1.0 x 10
5
CD3 + cells/kg, respectively,
without relevant transfusion-related side-effects.
Results: All patients showed sustained hematopoietic engraftment. One patient developed acute and chronic intestinal GVHD
and died on day + 140 of Aspergillus pneumonia in remission of
leukemia. The other three patients had an uneventful posttransplant course with a current follow-up of 138, 59 and 21 days
without GVHD or other complications.
Conclusions: Short-term cryopreservation of unrelated PBSC
allografts in pediatric patients is possible for compelling medical
or logistic reasons. The advantages of the use of cryopreserved
grafts must be individually outweighed against the concerns
raised but not defi nitely answered by the available data. In view
of the increasing use of manipulated grafts short-term cryopreservation might be an option to ensure optimum graft and
recipient conditions.

Abstract Number: P884

Conference Year: 2010

Link to conference website: NULL

New link: NULL

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