Effect of Cryopreservation in Unrelated Bone Marrow and Peripheral Blood Stem Cell Transplantation in the Era of the COVID-19 Pandemic: An Update from the Japan Marrow Donor Program

Yoshinobu Kanda, Noriko Doki, Minoru Kojima, Shinichi Kako, Masami Inoue, Naoyuki Uchida, Yasushi Onishi, Reiko Kamata, Mika Kotaki, Ryoji Kobayashi, Junji Tanaka, Takahiro Fukuda, Nobuharu Fujii, Koichi Miyamura, Shin Ichiro Mori, Yasuo Mori, Yasuo Morishima, Hiromasa Yabe, Yoshiko Atsuta, Yoshihisa Kodera

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

During the COVID-19 pandemic, donor grafts are frequently cryopreserved to ensure that a graft is available before starting a conditioning regimen. However, there have been conflicting reports on the effect of cryopreservation on transplantation outcomes. Also, the impact of cryopreservation may differ in bone marrow (BM) transplantation (BMT) and peripheral blood stem cell (PBSC) transplantation (PBSCT). In this retrospective study, we analyzed the clinical data of both cryopreserved unrelated BMTs (n = 235) and PBSCTs (n = 118) and compared these with data from a large control cohort without cryopreservation including 4133 BMTs and 720 PBSCTs. Among the patients with cryopreserved grafts, 10 BMT recipients (4.3%) and 3 PBSCT recipients (2.5%) did not achieve neutrophil engraftment after transplantation, including 4 of the former and all 3 of the latter who died early before engraftment. In a multivariate analysis, cryopreservation was not associated with neutrophil engraftment in BMT but significantly delayed neutrophil engraftment in PBSCT (hazard ratio [HR],. 82; 95% confidence interval [CI],. 69 to. 97; P = .023). There was an interaction with borderline significance between cryopreservation and the stem cell source (P = .067). Platelet engraftment was delayed by cryopreservation after both BMT and PBSCT. Only 2 cryopreserved grafts (<1%) were unused during the study period. The cryopreservation of unrelated donor BM and PBSC grafts is associated with a slight delay in neutrophil and platelet engraftment but an acceptable rate of graft failure. PBSC grafts may be more sensitive to cryopreservation than BM grafts. Cryopreservation is a reasonable option during COVID-19 pandemic, provided that the apheresis and transplantation centers are adept at cryopreservation.

Original languageEnglish
Pages (from-to)677.e1-677.e6
JournalTransplantation and Cellular Therapy
Volume28
Issue number10
DOIs
Publication statusPublished - Oct 2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Molecular Medicine
  • Hematology
  • Cell Biology
  • Transplantation

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