Clinical Impact of Graft Cryopreservation on Allogeneic Stem Cell Transplantation: An Italian, Registry‐Based Study on Behalf of the “Gruppo Italiano Per Il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare” (GITMO)

The coronavirus disease 2019 (COVID-19) pandemic created major challenges for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Scientific societies and authorities recommended cryopreserving grafts before starting conditioning regimens, despite limited data on the clinical impact. The Italian Group for Bone Marrow Transplantation (GITMO) conducted a registry-based study involving 3492 patients who underwent allo-HSCT between March 2018 and September 2021. The cryopreserved cohort (n = 976) included patients who received cryopreserved grafts during the pandemic and was compared to the historical cohort (n = 2516). Graft cryopreservation was associated with a lower day 30 incidence of neutrophil and platelet engraftment (adjusted sHR = 0.8 and 0.7, p = 0.031 and p < 0.001, respectively) and delayed hematopoietic recovery. However, primary graft failure rates at day +30 were similar in the cryo and historical cohort (4% vs. 5%, respectively; p = 0.337), also after adjustment (RR = 1.19, p = 0.518). Day 100 incidence of grade II-IV acute GVHD was comparable between the two groups (adjusted sHR = 1.2, p = 0.194). Regarding chronic GVHD incidence, we found that it was higher in patients aged < 18 years in the cryo group (adjusted sHR = 3.9, p = 0.002), but lower in those aged 18-55 years (adjusted sHR = 0.7, p = 0.008). Cumulative incidence of relapse did not differ between historical and cryo cohort (adjusted sHR 1.0. p = 0.943), as well as non-relapse mortality (adjusted sHR 1.1, p = 0.196) and relapse-free survival (adjusted sHR = 1.1, p = 0.197). However, a shorter overall survival was observed in the cryopreserved group (adjusted HR = 1.2, p = 0.038). Transplant centers should carefully balance the benefits and drawbacks of cryopreservation in allo-HSCT.

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Publication Details

Journal
American Journal of Hematology
Published
2025-06-02
DOI
https://doi.org/10.1002/ajh.27731
Citations
2
Primary Topic
Hematopoietic Stem Cell Transplantation
Type
article
Field-Weighted Citation Impact
3.54

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article

Clinical Impact of Graft Cryopreservation on Allogeneic Stem Cell Transplantation: An Italian, Registry‐Based Study on Behalf of the “Gruppo Italiano Per Il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare” (GITMO)

Francesco Romano, A. Taurino, Paola Carluccio, Nicola Polverelli et al.
2 citations
American Journal of Hematology
Hematopoietic Stem Cell Transplantation
3.54
article

Clinical Impact of Graft Cryopreservation on Allogeneic Stem Cell Transplantation: An Italian, Registry‐Based Study on Behalf of the “Gruppo Italiano Per Il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare” (GITMO)

Francesco Romano, A. Taurino, Paola Carluccio, Nicola Polverelli, Virginia Valeria Ferretti, Elena Oldani, Simone Cesaro, Luca Castagna, Alessandra Biffi, Attilio Olivieri, Alessandra Picardi, Roberto Cairoli, Carmine Selleri, Domenico Russo, Giulia Losi, Chiara Nozzoli, Alessandro Busca, Patrizia Chiusolo, Daniele Vallisa, Stéfania Bramanti, Antonio M. Risitano, Maura Faraci, Massimiliano Gambella, Caterina Zerbi, Monica Tozzi, Matteo Parma, Fabrizio Pane, Francesco Onida, Veronica Tintori, Arcangelo Prete, Piero Galieni, Vincenzo Pavone, Giuseppe Milone, Lucia Prezioso, Carlo Borghero, Domenico Pastore, Franca Fagioli, Francesca Bonifazi, Irene Cavattoni, Antonio Bianchessi, Irene Defrancesco, Massimo Vincenzo Martino, Nicola Mordini, Simona Piemontese, Francesco Paolo Tambaro, Stella Santarone, Fabio Benedetti, Angela Cuoghi, Maurizio Musso, Cristina Skert, Renato Fanin, Anna Paola Iori, Marco Ladetto
article en
2 citations

Abstract

The coronavirus disease 2019 (COVID-19) pandemic created major challenges for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Scientific societies and authorities recommended cryopreserving grafts before starting conditioning regimens, despite limited data on the clinical impact. The Italian Group for Bone Marrow Transplantation (GITMO) conducted a registry-based study involving 3492 patients who underwent allo-HSCT between March 2018 and September 2021. The cryopreserved cohort (n = 976) included patients who received cryopreserved grafts during the pandemic and was compared to the historical cohort (n = 2516). Graft cryopreservation was associated with a lower day 30 incidence of neutrophil and platelet engraftment (adjusted sHR = 0.8 and 0.7, p = 0.031 and p < 0.001, respectively) and delayed hematopoietic recovery. However, primary graft failure rates at day +30 were similar in the cryo and historical cohort (4% vs. 5%, respectively; p = 0.337), also after adjustment (RR = 1.19, p = 0.518). Day 100 incidence of grade II-IV acute GVHD was comparable between the two groups (adjusted sHR = 1.2, p = 0.194). Regarding chronic GVHD incidence, we found that it was higher in patients aged < 18 years in the cryo group (adjusted sHR = 3.9, p = 0.002), but lower in those aged 18-55 years (adjusted sHR = 0.7, p = 0.008). Cumulative incidence of relapse did not differ between historical and cryo cohort (adjusted sHR 1.0. p = 0.943), as well as non-relapse mortality (adjusted sHR 1.1, p = 0.196) and relapse-free survival (adjusted sHR = 1.1, p = 0.197). However, a shorter overall survival was observed in the cryopreserved group (adjusted HR = 1.2, p = 0.038). Transplant centers should carefully balance the benefits and drawbacks of cryopreservation in allo-HSCT.

American Journal of HematologyVol. 100(8)
University of Siena (IT), Università Cattolica del Sacro Cuore (IT), University of Modena and Reggio Emilia (IT), Marche Polytechnic University (IT), University of Padua (IT), Vita-Salute San Raffaele University (IT), University of Milan (IT), University of Pavia (IT), Policlinico Umberto I (IT), Istituto Giannina Gaslini (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Ospedale Maggiore (IT), Ospedale Antonio Cardarelli (IT), Ospedale di Bolzano (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Azienda Ospedaliera Universitaria Integrata Verona (IT), Azienda ospedaliera "Bianchi-Melacrino-Morelli" (IT), Ospedale Vincenzo Cervello (IT), Azienda Unità Sanitaria Locale di Ferrara (IT), Ospedale A. Perrino (IT), Ospedale Papa Giovanni XXIII (IT), Azienda Ospedaliera San Gerardo (IT), Azienda Ospedaliera S.Giuseppe Moscati (IT), Meyer Children's Hospital (IT), Azienda Ospedaliero-Universitaria Careggi (IT), Azienda USL di Bologna (IT), Santobono Children's Hospital (IT), Azienda Sanitaria Locale Alessandria (IT), Policlinico Universitario di Catania (IT), IRCCS Ospedale San Raffaele (IT), Ospedali Riuniti San Giovanni di Dio e Ruggi d'Aragona (IT), Ospedale di Parma (IT), Ospedale Regina Margherita (IT), Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT), Guglielmo da Saliceto Hospital (IT), Ospedale dell' Angelo (IT), Ospedale Policlinico San Martino (IT), Azienda USL di Pescara (IT), Piedmont Reference Center for Epidemiology and Cancer Prevention (IT), Policlinico San Matteo Fondazione (IT), Ospedale San Bortolo (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), ASST Fatebenefratelli Sacco (IT), IRCCS Humanitas Research Hospital (IT), University of Turin (IT), University of Milano-Bicocca (IT), University of Naples Federico II (IT), University of Brescia (IT), Sapienza University of Rome (IT), University of Palermo (IT)
Università degli Studi di Napoli Federico II, Università Degli Studi di Modena e Reggio Emila, Università degli Studi di Milano, Sapienza Università di Roma, Università degli Studi di Pavia, Università degli Studi di Torino
Openalex Percentile: Top 8%
Hematopoietic Stem Cell Transplantation
3.54
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