Original Article
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Blood Res 2017; 52(4):
Published online December 31, 2017
https://doi.org/10.5045/br.2017.52.4.307
© The Korean Society of Hematology
Is long term storage of cryopreserved stem cells for hematopoietic stem cell transplantation a worthwhile exercise in developing countries?
1Department of Medical Oncology and Bone Marrow Transplantation, Tata Memorial Center, Advanced Center for Treatment, Research and Education in Cancer (ACTREC), Mumbai, India.
2Department of Transfusion Medicine, Tata Memorial Center, Advanced Center for Treatment, Research and Education in Cancer (ACTREC), Mumbai, India.
3Statistics, Tata Memorial Center, Advanced Center for Treatment, Research and Education in Cancer (ACTREC), Mumbai, India.
Correspondence to : Navin Khattry, M.D. Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata Memorial Center, Mumbai 410210, India. nkhattry@gmail.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background
Stem cell units (SCUs) that are cryopreserved prior to both autologous and allogeneic hematopoietic stem cell transplants (for donor lymphocyte infusion) remain unused or partially used several times, and become an increased burden to blood banks/SCU repositories. Because of the scarcity of data regarding the duration for which the storage is useful, there is no general consensus regarding disposal of SCUs.
Methods
We conducted a retrospective audit of SCU utilization in 435 patients who planned to undergo either autologous stem cell transplantation (auto-SCT) (N=239) or allogeneic stem cell transplantation (allo-SCT) (N=196) at a tertiary cancer care center between November 2007 to January 2015.
Results
Our cohort consisted of 1,728 SCUs stored for conducting auto-SCT and 729 SCUs stored for conducting donor lymphocyte infusions (DLIs) after allo-SCT. Stem cells were not infused in 12.5% of patients who had planned to undergo auto-SCT, and 80% of patients who underwent allo-SCT never received DLI. Forty-one percent of SCUs intended for use in auto-SCT remained unutilized, with a second auto-SCT being performed only in 4 patients. Ninety-four percent of SCUs intended for carrying out DLIs remained unused, with only minimal usage observed one year after undergoing allo-SCT.
Conclusion
The duration of storage of unused SCUs needs to be debated upon, so that a consensus can be reached regarding the ethical disposal of SCU.
Keywords Cryopreservation, Stem cell, Long term, Developing
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Original Article
Blood Res 2017; 52(4): 307-310
Published online December 31, 2017 https://doi.org/10.5045/br.2017.52.4.307
Copyright © The Korean Society of Hematology.
Is long term storage of cryopreserved stem cells for hematopoietic stem cell transplantation a worthwhile exercise in developing countries?
Santhosh Kumar Devadas1, Minal Khairnar2, Sumathi S Hiregoudar2, Shashank Ojha2, Sachin Punatar1, Alok Gupta1, Anant Gokarn1, Pallavi Bhole3, Sadhana Kannan3, and Navin Khattry1*
1Department of Medical Oncology and Bone Marrow Transplantation, Tata Memorial Center, Advanced Center for Treatment, Research and Education in Cancer (ACTREC), Mumbai, India.
2Department of Transfusion Medicine, Tata Memorial Center, Advanced Center for Treatment, Research and Education in Cancer (ACTREC), Mumbai, India.
3Statistics, Tata Memorial Center, Advanced Center for Treatment, Research and Education in Cancer (ACTREC), Mumbai, India.
Correspondence to:Navin Khattry, M.D. Department of Medical Oncology, Bone Marrow Transplant Unit, ACTREC, Tata Memorial Center, Mumbai 410210, India. nkhattry@gmail.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Stem cell units (SCUs) that are cryopreserved prior to both autologous and allogeneic hematopoietic stem cell transplants (for donor lymphocyte infusion) remain unused or partially used several times, and become an increased burden to blood banks/SCU repositories. Because of the scarcity of data regarding the duration for which the storage is useful, there is no general consensus regarding disposal of SCUs.
Methods
We conducted a retrospective audit of SCU utilization in 435 patients who planned to undergo either autologous stem cell transplantation (auto-SCT) (N=239) or allogeneic stem cell transplantation (allo-SCT) (N=196) at a tertiary cancer care center between November 2007 to January 2015.
Results
Our cohort consisted of 1,728 SCUs stored for conducting auto-SCT and 729 SCUs stored for conducting donor lymphocyte infusions (DLIs) after allo-SCT. Stem cells were not infused in 12.5% of patients who had planned to undergo auto-SCT, and 80% of patients who underwent allo-SCT never received DLI. Forty-one percent of SCUs intended for use in auto-SCT remained unutilized, with a second auto-SCT being performed only in 4 patients. Ninety-four percent of SCUs intended for carrying out DLIs remained unused, with only minimal usage observed one year after undergoing allo-SCT.
Conclusion
The duration of storage of unused SCUs needs to be debated upon, so that a consensus can be reached regarding the ethical disposal of SCU.
Keywords: Cryopreservation, Stem cell, Long term, Developing
Fig 1.
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Donor lymphocyte infusion after allogeneic stem cell transplantation.
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Details of stem cell units stored for autologous stem cell transplantation. Abbreviations: AML, acute myeloid leukemia; HL, Hodgkin's lymphoma; MM, multiple myeloma; NB, neuroblastoma; NHL, Non-Hodgkin's lymphoma; SCU, stem cell unit; Other, other solid tumors..
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Use of SCUs stored for donor lymphocyte infusion. Abbreviations: AA, aplastic anemia; ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; CML, chronic myeloid leukemia; DLI, donor lymphocyte infusion; HL, Hodgkin's lymphoma; MDS, myelodysplastic syndrome; SCU, stem cell unit..
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