A Real-World data of 100 Day outcomes of Multiple Myeloma patients undergoing Autologous Stem Cell Transplant using Non-Cryopreserved Stem Cells
DOI:
https://doi.org/10.48047/HM.11.1.2025.65-72Abstract
Background: The preferred treatment for newly diagnosed multiple myeloma (NDMM) patients is proteasome inhibitor-based induction followed by autologous stem cell transplant (ASCT) consolidation. Historically cryopreserved stem cells were used for ASCT in multiple myeloma (MM), however post coronavirus pandemic, non-cryopreserved stem cells are used increasingly.
Aim: To evaluate the 100 days outcome of ASCT using non-cryopreserved stem cells in MM patients.
Methods: This research included seventy patients who underwent ASCT using non-cryopreserved stem cells for MM between January 2009 and September 2023 at the department of clinical haematology and bone marrow transplant, National University of Medial Sciences, Rawalpindi Pakistan.
Results: At the time of transplant, the median age of the patients was 49.97(± 9.79) years. The ratio of male to female was 3:1. The most frequently reported symptom was backache in 49(70%) patients while anaemia was the most common laboratory abnormality in 51(73%) patients. For most of the patients (70%) Cyclophosphamide combined with granulocyte colony stimulating factor (GCSF) was used for stem cell mobilization. At the time of ASCT, 29 (43%) patients were in stringent complete remission, 37 (55%) patients were in complete remission,1(2%) was in less than partial remission. The conditioning regimen used most commonly in 60 (85%) patients was Melphalan 200 mg/m2 while Melphalan 140 mg/m2 was used in 10 (15 %) patients. The median days for engraftment of neutrophils and platelets were 11(IQR 10.75-12) and 16 (IQR 15-18 respectively. The median duration of hospitalisation after transplant was 14 days (IQR: 13 to 16). Febrile neutropenia was documented in 54 (77%) patients, gut toxicity in 52 (74%) were most frequent complications. There was no graft failure and overall and disease-free survival was 100% at day 100.
Conclusion: Non-cryopreserved stem cells offer a cheaper, convenient and effective alternative for the cryopreserved stem cells. Non-cryopreserved stem cells were associated with rapid neutrophil and platelet engraftment and should be preferred stem cell source in resource limited centres.
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