Contributions
Abstract: EP997
Type: E-Poster Presentation
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
Patients with diagnosis of multiple myeloma (MM) who are candidates to receive an autologous hematopoietic stem cell transplant (Auto-HSCT) are stimulated to harvest stem cells from the peripheral blood. These cells can be either cryopreserved with Dimethyl sulfoxide (DMS) for later use or stored in liquid state at 4ºC for up to 5 days to be reinfused after a 48-hours- conditioning regimen with a total dose of 200mg/m2 of Melphalan. Potential advantages of non-cryopreserved stem cells are a decrease in apoptotic progenitors, the avoidance of DMS toxicity, and a reduction in the use of economic resources.
Aims
To compare acute complication, transfusional requirement, and time to hematologic recovery between patients with MM that receive cryopreserved (CRYO) and non-cryopreserved (non-CRYO) autologous stem cells.
Methods
Observational, retrospective trial that included pacientes with MM who received Auto-HSCT between January 2018 to January 2021 at a high complexity center.
Results
62 pacientes received transplant on the study period. 4 were excluded due to missing important data. 21 patients received non-CRYO cells whereas 37 received CRYO products. Median age was 55±9.53 years; 59% were males. Median number of chemotherapy cycles was 6 cycles; 47% were on complete remission, 21% very good partial remission, and 33% on partial remission. Before harvesting, 52% versus 75% patients require addition of plerixafor in the non-CRYO and CRYO groups, respectively (p=0.72). The mean amount of CD34+/kg infused cells was 7.7±1.6 x106 for the non-CRYO patients versus 6.6±2.4 x106 for the CRYO group (p=0.44).
Incidence of febrile neutropenia was 61% non-CRYO vs 91% CRYO (p=0.01). There were no cases of severe sepsis nor dialysis requirements. Incidence of grade IV mucositis was 19% non-CRYO vs 45% CRYO (p=0.08). Requirement of parental nutricion was 42% non-CRYO vs 78% CRYO (p=0.01).
Platelet transfusion requirement was 10.05±10.70 units for non-CRYO and 11.68±8.27 units for the CRYO group (p=0.18). The median amount of red blood cells units was 0.67±2.22 units in the non-CRYO group versus 0.62±1.52units in the CRYO group (p=0.55).
Time in days to neutrophil recovery (>500/mm3 for 2 consecutive days) was 10.52±1.29 non-CRYO vs 12.89±2.23 CRYO (p>0.001). In the case of platelet recovery (>30.000/mm3 without transfusion in the last 3 days), it took 13.14±7.25 days non-CRYO versus 15.51±4.19 days CRYO (p<0.001). Median hospital stay was 13 ±2.55 non CRYO versus 16±4.11 CRYO (p<0.001). There were no transplant-related deaths in either group.
Conclusion
Auto-HSCT in MM using non-cryopreserved cells is a safe and effective technique associated with a decrease in febrile neutropenia incidence, lower parenteral nutrition requirement, faster hematologic recovery and shorter hospital stay, making it more cost-effective. Besides, it showed a tendency to a lower incidence of severe mucositis. There was no significant impact on transfusion requirement and on mortality associated with the transplant. Further studies are needed to evaluate long-term outcomes.
Keyword(s): Autologous hematopoietic stem cell transplantation, Cryopreservation, Multiple myeloma
Abstract: EP997
Type: E-Poster Presentation
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
Patients with diagnosis of multiple myeloma (MM) who are candidates to receive an autologous hematopoietic stem cell transplant (Auto-HSCT) are stimulated to harvest stem cells from the peripheral blood. These cells can be either cryopreserved with Dimethyl sulfoxide (DMS) for later use or stored in liquid state at 4ºC for up to 5 days to be reinfused after a 48-hours- conditioning regimen with a total dose of 200mg/m2 of Melphalan. Potential advantages of non-cryopreserved stem cells are a decrease in apoptotic progenitors, the avoidance of DMS toxicity, and a reduction in the use of economic resources.
Aims
To compare acute complication, transfusional requirement, and time to hematologic recovery between patients with MM that receive cryopreserved (CRYO) and non-cryopreserved (non-CRYO) autologous stem cells.
Methods
Observational, retrospective trial that included pacientes with MM who received Auto-HSCT between January 2018 to January 2021 at a high complexity center.
Results
62 pacientes received transplant on the study period. 4 were excluded due to missing important data. 21 patients received non-CRYO cells whereas 37 received CRYO products. Median age was 55±9.53 years; 59% were males. Median number of chemotherapy cycles was 6 cycles; 47% were on complete remission, 21% very good partial remission, and 33% on partial remission. Before harvesting, 52% versus 75% patients require addition of plerixafor in the non-CRYO and CRYO groups, respectively (p=0.72). The mean amount of CD34+/kg infused cells was 7.7±1.6 x106 for the non-CRYO patients versus 6.6±2.4 x106 for the CRYO group (p=0.44).
Incidence of febrile neutropenia was 61% non-CRYO vs 91% CRYO (p=0.01). There were no cases of severe sepsis nor dialysis requirements. Incidence of grade IV mucositis was 19% non-CRYO vs 45% CRYO (p=0.08). Requirement of parental nutricion was 42% non-CRYO vs 78% CRYO (p=0.01).
Platelet transfusion requirement was 10.05±10.70 units for non-CRYO and 11.68±8.27 units for the CRYO group (p=0.18). The median amount of red blood cells units was 0.67±2.22 units in the non-CRYO group versus 0.62±1.52units in the CRYO group (p=0.55).
Time in days to neutrophil recovery (>500/mm3 for 2 consecutive days) was 10.52±1.29 non-CRYO vs 12.89±2.23 CRYO (p>0.001). In the case of platelet recovery (>30.000/mm3 without transfusion in the last 3 days), it took 13.14±7.25 days non-CRYO versus 15.51±4.19 days CRYO (p<0.001). Median hospital stay was 13 ±2.55 non CRYO versus 16±4.11 CRYO (p<0.001). There were no transplant-related deaths in either group.
Conclusion
Auto-HSCT in MM using non-cryopreserved cells is a safe and effective technique associated with a decrease in febrile neutropenia incidence, lower parenteral nutrition requirement, faster hematologic recovery and shorter hospital stay, making it more cost-effective. Besides, it showed a tendency to a lower incidence of severe mucositis. There was no significant impact on transfusion requirement and on mortality associated with the transplant. Further studies are needed to evaluate long-term outcomes.
Keyword(s): Autologous hematopoietic stem cell transplantation, Cryopreservation, Multiple myeloma