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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References
Małecki, B., L. Gil, and D.J.A.H.P. Dytfeld, Role of transplantation in treatment of multiple myeloma in era of novel agents. 2021. 52(2): p. 77-84.
Du, J., J.J.C.D. Zhuang, and T. Medicine, Major advances in the treatment of multiple myeloma in American Society of Hematology annual meeting 2020. 2021. 7(04): p. 220-226. https://mednexus.org/doi/full/10.1016/j.cdtm.2021.08.003
Charliński, G. and A.J.B.P.T.O.N. Jurczyszyn, Multiple myeloma–2020 update on diagnosis and management. 2020. 5(5): p. 241-251.
Abdrabou, A.K., et al., Outcomes of autologous stem cell transplantation for multiple myeloma in Saudi Arabia. 2021. 41(4): p. 198-205. https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2021.198
Rajkumar, S.V.J.A.j.o.h., Multiple myeloma: 2020 update on diagnosis, risk‐stratification and management. 2020. 95(5): p. 548-567. https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.25117
Padala, S.A., et al., Epidemiology, staging, and management of multiple myeloma. 2021. 9(1): p. 3. https://www.mdpi.com/2076-3271/9/1/3
Al-Anazi, K.A., Z. Alshaibani, and P. Kalogianidis, An Update on Hematopoietic Stem Cell Transplantation in Patients with Multiple Myeloma, in Recent Updates on Multiple Myeloma. 2023, IntechOpen. https://www.intechopen.com/chapters/85327
Naithani, R., et al., Hematopoietic stem cell transplantation using non-cryopreserved peripheral blood stem cells graft is effective in multiple myeloma and lymphoma. 2018. 53(9): p. 1198-1200. https://www.nature.com/articles/s41409-018-0174-9
Bekadja, M.A., Non-cryopreserved Peripheral Stem Cell Autograft for Multiple Myeloma and Lymphoma in Countries with Low Resources, in Handbook of Stem Cell Therapy. 2022, Springer. p. 1421-1443. https://link.springer.com/referenceworkentry/10.1007/978-981-19-2655-6_52
Jennane, S., et al., Non-cryopreserved peripheral blood stem cells autologous transplantation in multiple myeloma: Bicentric study. 2020. 27(3): p. 152-156. https://www.sciencedirect.com/science/article/abs/pii/S1246782020300537
Piriyakhuntorn, P., et al., Outcomes of non-cryopreserved versus cryopreserved peripheral blood stem cells for autologous stem cell transplantation in multiple myeloma. Annals of Transplantation, 2020. 25: p. e927084-1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737409/
Pessoa, J.M., et al., Cryopreserved versus non-cryopreserved stem cell autografts in multiple myeloma a restrospective cohort study. 2022. 57(8): p. 1313-1318. https://www.nature.com/articles/s41409-022-01718-2
Uysal, A., et al., The effect of cryopreserved and noncryopreserved stem cells on the outcome of autologous stem-cell transplantation in multiple myeloma patients: A single-center experience. 2022. 47(3): p. 181-186. https://journals.lww.com/egjh/fulltext/2022/47030/the_effect_of_cryopreserved_and_noncryopreserved.4.aspx
Joseph, J., et al., Fresh versus cryopreserved peripheral stem cell for autologous transplantation in multiple myeloma: An analysis of short-term outcomes. Blood, 2020. 136: p. 9-10. https://www.sciencedirect.com/science/article/pii/S0006497118733181
Castellanos, L., et al., 241.5: Cryopreserved vs Non-cryopreserved Graft Before Autologous Stem Cell Transplantation in Patients With Multiple Myeloma. A Comparative Study. Transplantation, 2022. 106(9S): p. S127. https://journals.lww.com/transplantjournal/fulltext/2022/09001/241_5__Cryopreserved_vs_Non_cryopreserved_Graft.190.aspx
Al Saleh, A.S., et al., Differences in engraftment with day-1 compared with day-2 melphalan prior to stem cell infusion in myeloma patients receiving autologous stem cell transplant. 2020. 55(11): p. 2132-2137. https://www.nature.com/articles/s41409-020-0916-3
Kumar, L., et al., Multiple myeloma: impact of time to transplant on the outcome. 2022. 22(9): p. e826-e835. https://www.sciencedirect.com/science/article/abs/pii/S2152265022001355
Kumar, L., et al., Multiple Myeloma—Effect of Induction Therapy on Transplant Outcomes. 2021. 21(2): p. 80-90. e5. https://www.sciencedirect.com/science/article/abs/pii/S2152265020305085
Turunen, A., et al., CD34+ cell mobilization, blood graft composition, and posttransplant recovery in myeloma patients compared to non‐Hodgkinʼs lymphoma patients: results of the prospective multicenter GOA study. 2020. 60(7): p. 1519-1528. https://onlinelibrary.wiley.com/doi/full/10.1111/trf.15820
Lemieux, C., et al., Outcomes after delayed and second autologous stem cell transplant in patients with relapsed multiple myeloma. 2021. 56(11): p. 2664-2671. https://www.nature.com/articles/s41409-021-01371-1
Zheng-Lin, B., et al., Duration of Post-Autologous Hematopoietic Cell Transplant Anemia and Thrombocytopenia Are Associated with Prolonged Hospital Length-of-Stay for Multiple Myeloma Patients. 2020. 136: p. 5-6. https://www.sciencedirect.com/science/article/pii/S0006497118724245
Marini, J., et al., Effectiveness, safety, and cost implications of outpatient autologous hematopoietic stem cell transplant for multiple myeloma. Hematology/Oncology and Stem Cell Therapy, 2023. 16(4): p. 351-357. https://journals.lww.com/hosct/fulltext/2023/16040/effectiveness,_safety,_and_cost_implications_of.9.aspx
Voloshin, S., et al., The Comparison of Results of Autologous Transplantation Using Non-Cryopreserved and Cryopreserved Hematopoietic Stem Cells (HSC). Blood, 2020. 136: p. 5-6. https://www.sciencedirect.com/science/article/pii/S0006497118733144
Sarmiento, M., et al., Advantages of non-cryopreserved autologous hematopoietic stem cell transplantation against a cryopreserved strategy. Bone Marrow Transplantation, 2018. 53(8): p. 960-966. https://www.nature.com/articles/s41409-018-0117-5
Yadav, N., et al., Second stem cell transplantation for treatment of relapsed/refractory multiple myeloma after first autologous stem cell transplant: A 15-year retrospective institutional analysis. Indian Journal of Cancer, 2023. 60(3): p. 316-324. https://journals.lww.com/indianjcancer/_layouts/15/oaks.journals/downloadpdf.aspx?an=02223310-202360030-00005
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