ISSN 1866-8836
Клеточная терапия и трансплантация

DT-01. Graft preservation in haploidentical SCT with post-transplant cyclophosphamide: single center experience

Renat S. Badaev1, Darina B. Zammoeva1, Anastasiya I. Reshetova1, Vasiliy S. Chistyakov1, Alexander Yu. Pestakov1, Larisa L. Girshova1, Irina G. Budaeva1, Nadiya T. Siordiya1, Yuliya A. Alekseeva1, Elza G. Lomaia1, Dmitriy V. Motorin2, Andrey Yu. Zaritskey1

1 Almazov National Medical Research Centre, St. Petersburg, Russia
2 Russian Research Institute of Hematology and Transfusiology, St. Petersburg, Russia


Contact: Dr. Renat S. Badaev, e-mail: r.badaev89@gmail.com

doi 10.18620/ctt-1866-8836-2023-12-3-1-176

Summary

Haploidentical stem cell transplantation (haplo-SCT) is often used as a treatment option in the absence of HLA-matched donor. Cryopreservation of the graft allows pre-preparation of the bone marrow, which has become especially important during the COVID-19 epidemic. As cryopreservation remains to be relatively less studied in the context of haplo-SCT, we conductеd a retrospective analysis of its feasibility in our patients.

Patients and methods

Medical records search identified 113 patients with various oncohematological diseases, who received haplo-SCT with (n=68) or without (n=64) graft cryopreservation between 2015 and 2020. Patient characteristics are presented in Table 1. The cryoprotectant used was Dimethyl sulfoxide. As conditioning regimen was chosen one of the non-myeloablative variant of the same intensity. Graft-versus-host disease (GvHD) prevention with post-transplant cyclophosphamide in combination with calcineurin inhibitor and mycophenolate mofetil was used in all patients.

Results

Both cohorts of patients were comparable in terms of recipient age and gender, disease activity, graft source, and rates of major AB0 incompatibility. Age of donors was significantly higher in cryopreserved graft recipients (45 vs 37 years, p=0.017). Rates of acute and chronic GvHD, disease relapse, as well as progression free survival (PFS) and overall survival (OS) did not significantly differ between the two studied cohorts. There was also no difference in terms of graft failure, granulocyte and thrombocyte recovery. Although, in univariate analysis, cryopreservation significantly increased risk of graft rejection (34.3% vs 15.4%, p=0.02) and secondary graft failure (19.5% vs 4.4%, p=0.02). In multivariate analysis, there was only a trend towards increased risk of secondary graft failure with cryopreservation (p=0.096).

Conclusion

As a summary, our data suggest that graft cryopreservation during haplo-SCT with post-transplant cyclophosphamide has no negative impact on key stem cell transplantation (SCT) endpoints.

Keywords

Cryopreservation, stem cells transplantation, haploidentical, cyclophsphamide posttransplant.



Table 1. Characteristics of patients

Badaev-tab01.jpg

Note: TNC, total nucleated cell count

Supplement 12-3
09/30/2023

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doi 10.18620/ctt-1866-8836-2023-12-3-1-176

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