Retrospective Study of Implementation and Outcomes of a Non-Cryopreserved Autologous Hematopoietic Stem Cell Transplantation Program for Patients With Hematologic Malignancy in a Resource-Limited Center in Chile

Background:Autologous hematopoietic progenitor cell transplantation (ASCT) is the standard treatment for many hematologic malignancies, and is usually performed with cryopreservation.However, many centers in resource-limited settings perform ASCT without cryopreservation.This retrospective study evaluated the feasibility and outcomes of implementing a non-cryopreserved ASCT program for hematologic malignancy in a public health system hospital in Chile, located far from the capital city and without local cryopreservation facilities. Material/Methods:A retrospective study of consecutive peripheral blood ASCT procedures was performed at Hospital Base Valdivia in patients older than 15 and younger than 62 years, between June 2018 and July 2024.Data were extracted from patients' medical records.Overall survival was estimated using the Kaplan-Meier method and hazard ratios, and 95% confidence intervals were calculated using univariable Cox proportional hazards models. Results:A total of 140 patients underwent ASCT: 81 with multiple myeloma, 31 with Hodgkin lymphoma, and 28 with non-Hodgkin lymphoma.Mobilization failure occurred in 4 patients.There was no transplant-related mortality or graft failure.Median time to neutrophil engraftment was 10.9 days, and median time to platelet engraftment was 12.3 days.Febrile neutropenia occurred in 45% of patients.Overall survival at 6 years was 83% for the entire cohort, and 96%, 88%, and 76% for non-Hodgkin lymphoma, Hodgkin lymphoma, and multiple myeloma, respectively (P = 0.41). Conclusions:In this retrospective single-center public-hospital experience, non-cryopreserved ASCT was feasible without local backup cryopreservation facilities, and was associated with acceptable engraftment, early transplant-related mortality, and encouraging survival outcomes.