PBSC components are routinely frozen for storage before autologous transplantation in the treatment of malignant diseases. We have used 5% DMSO, 3.75% human serum albumin (HSA), 0.2% dextrose with 6% HES for cryopreservation of cells (DMSO/HES), but the lack of a commercial source of HES required us to evaluate other cryopreservative solutions. A solution containing 5% DMSO, 2.25% HSA in normal saline (DMSO) was selected from a range of cryoprotectant solutions based on in vitro data demonstrating equivalence in preservation of hematopoietic colony forming ability to the HES solution previously used at this center. Fifteen months after the change, we performed a retrospective review of engraftment kinetics in autologous PBSC transplantation for the treatment of patients classified by cryoprotectant solution used. PBSC collected before 13-June-2006 were frozen in the DMSO/HES solution. PBSC collected after that date were frozen in DMSO. Patients underwent transplantation using dose-intense preparative regimens appropriate to diagnosis. Filgrastim was administered after transplantation to hasten granulocyte recovery. All patients after the change date were evaluated and patients treated in a similar time frame before the change were selected for comparison. Patient demographics and mean CD34+ cell number infused were similar for these two groups.

Demographics

NAgeCD34+ Cells/Kg (xE6)Gender (M:F)Diagnosis (MM:NHL:Other)
Shown are median age and mean CD34+ cells/kg transplanted. Diagnosis is MM=multiple myeloma, NHL=non-Hodgkin’s lymphoma, and Other = other hematological malignancies. 
DMSO/HES 122 56 7.6 59:63 75:34:13 
DMSO 103 58 7.1 55:48 79:14:10 
p Value  0.26 0.56 0.17 0.84 
NAgeCD34+ Cells/Kg (xE6)Gender (M:F)Diagnosis (MM:NHL:Other)
Shown are median age and mean CD34+ cells/kg transplanted. Diagnosis is MM=multiple myeloma, NHL=non-Hodgkin’s lymphoma, and Other = other hematological malignancies. 
DMSO/HES 122 56 7.6 59:63 75:34:13 
DMSO 103 58 7.1 55:48 79:14:10 
p Value  0.26 0.56 0.17 0.84 
View Large

Patients who received PBSC frozen in DMSO/HES achieved a significant one-day faster granulocyte recovery but similar platelet recovery compared to patients receiving PBSC frozen in DMSO.

Engraftment Kinetics

NANC>500ANC>1000Platelet>20,000
Shown are median days to achieve particular endpoint of engraftment. 
DMSO/HES 122 11 12 13 
DMSO 103 12 13 14 
p Value  <0.001 0.002 0.83 
NANC>500ANC>1000Platelet>20,000
Shown are median days to achieve particular endpoint of engraftment. 
DMSO/HES 122 11 12 13 
DMSO 103 12 13 14 
p Value  <0.001 0.002 0.83 
View Large

Despite similar in vitro and patient demographic profiles, these data indicate that the combination cryoprotectant solution results in a clinically significant enhancement in speed of engraftment, resulting in a one (1) day reduction in hospital stay associated with the transplant regimen. The effect appears to be lineage-specific. Other modifications of cryoprotectant solutions may achieve yet faster engraftment, benefiting patients undergoing autologous PBSC transplantation by shortening the period of marrow hypoplasia. These results agree with another study of cryopreservation with and without HES (

Rowley, et al.
Bone Marrow Transpl
2003
;
31
:
1043
–51
).

Topics:
cryopreservation, dimethyl sulfoxide, granulocytes, hetastarch, peripheral blood stem cells, cryoprotective agents, transplantation, peripheral blood stem cell transplantation, bone marrow transplantation, bone marrow, hypocellular

Author notes

Disclosure: No relevant conflicts of interest to declare.

2007, The American Society of Hematology
2007
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