Post-thaw viability of cryopreserved hematopoietic progenitor cell grafts: does it matter? [Vijabilnost pripravka krvotvornih matičnih stanica nakon odmrzavanja: ima li kliničko značenje ili ne?]

Vrhovac, Radovan and Perić, Zinaida and Jurenec, Silvana and Kardum-Skelin, Ika and Jelić-Puškarić, Biljana and Jakšić, Branimir (2010) Post-thaw viability of cryopreserved hematopoietic progenitor cell grafts: does it matter? [Vijabilnost pripravka krvotvornih matičnih stanica nakon odmrzavanja: ima li kliničko značenje ili ne?]. Collegium Antropologicum, 34 (1). pp. 163-169. ISSN 0350-6134

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Abstract

Cell viability in peripheral blood progenitor cell (PBPC) grafts and its influence on the clinical course following transplantation was evaluated in 81 consecutive transplantations (72 autologous, 9 allogeneic) performed in patients with hematological diseases. Viability of cells in PBPC grafts immediately upon collection was 98.6±3.5%, after addition of dimethyl sulfoxide (DMSO) 73.3±21.8%, and post-thaw 65.2±16.1%. It did not differ significantly between patients with different diagnoses, gender, age, type of priming used, dose of G-CSF administered or number of CD34+ cells collected. However, grafts stored for more than 60 days showed lower post-thaw viability compared to the ones thawed in the 60 days following cryopreservation (56.6±15.2% vs. 67.6±15.5%, p=0.04). Post-thaw graft viability did not influence engraftment time, but there was a predisposition towards infectious complications in the post-transplant period in patients receiving grafts with lower percentage of viable cells. They developed febrile neutropenia more often (72.2% vs. 50% of patients, p=0.05) and had more febrile days (2.4±2.6 vs. 1.5±2.3, p=0.05) following transplantation. We have demonstrated that PBPC grafts are capable of long term engraftment regardless of the graft storage time or percentage of viable cells post-thaw, which confirms the robustness of CD34+ cells during the freeze/thaw procedures carried out in daily clinical practice. Granulocyte concentration in PBPC grafts could have an influence on infectious complications following transplantation and needs to be further investigated on a larger number of patients.

Abstract in Croatian

Vijabilnost pripravka krvotvornih matičnih stanica iz periferne krvi (KMSPK) i njen utjecaj na klinički tijek nakon transplantacije istraživani su kod 81 uzastopne transplantacije (72 autologne i 9 alogeničnih) provedene u bolesnika oboljelih od hematoloških bolesti. Vijabilnost stanica KMSPK odmah nakon sakupljanja bila je 98,6±3,5%, nakon dodatka dimetil sulfoksida 73,3±21,8%, a nakon odmrzavanja 65,2±16,1%. Nije se bitno razlikovala kod bolesnika različitih dijagnoza, dobi, spola, načina na koji su KMSPK mobilizirane, dozi G-CSFa ili broju prikupljenih CD34+ stanica. Pripravci zamrznuti dulje od 60 dana imali su slabiju vijabilnost nakon odmrzavanja u usporedbi s onima koji su bili zamrznuti manje od 60 dana (56,6±15,2% prema 67,6±15,5%, p=0,04). Vijabilnost nakon odmrzavanja nije utjecala na dinamiku hematopoetskog oporavka, no kod bolesnika kojima je vijabilnost pripravka KMSPK bila slabija uočena je sklonost infektivnim komplikacijama. Češće su razvili febrilnu neutropeniju (72,2% prema 50% bolesnika, p=0,05) te su imali više febrilnih dana (2,4±2,6 prema 1,5±2,3, p=0,05) nakon transplantacije. Pokazali smo da transplantacija KMSPK dovodi do hematopoetskog oporavka neovisno o tome koliko je dugo pripravak KMSPK bio zamrznut i neovisno o vijabilnosti stanica nakon odmrzavanja. Time se potvrdila otpornost CD34+ stanica na postupke zamrzavanja i odmrzavanja koji se rutinski provode u svakodnevnoj praksi. Moguće je da koncentracija granulocita u pripravku KMSPK ima utjecaj na razvoj infektivnih komplikacija nakon transplantacije, no taj je fenomen potrebno detaljnije istražiti na većem broju bolesnika.

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