Cryopreservative against noncryopreservative therapy in autologous hematopoietic stem cell transplantation (the Egyptian experience)

Abstract

Introduction Autologous peripheral blood stem cell transplantation is a 'rescue' of patients' self hematopoietic stem cells from the myeloablative effects of chemotherapy or irradiation. Cryopreservation of hematopoietic stem cells using 10% dimethyl sulfoxide as a cryoprotectant under liquid nitrogen storage conditions (−196°C) for long-term usage is a well-established procedure, whereas liquid preservation of stem cells is usually performed for storage at 4°C for 36-96 h. The aim of the study was to compare the outcome of autologous stem cell transplantation using cryopreserved or noncryopreserved stem cells. Patients and methods Twenty adult patients younger than 60 years of age were enrolled in this study. They had undergone autologous peripheral stem cell transplantation. They had been stratified into two groups: 10 patients received cryopreserved autologous peripheral stem cell transplantation (PBSCT) and the remaining 10 patients received noncryopreserved autologous PBSCT. Results When we compared the cryopreserved and the noncryopreserved groups for the clinical outcome, there had been a longer overall survival and disease-free survival in favor of the cryopreserved group, but this had not been translated into statistically significant values. In addition, there was no significant difference with regard to the recurrence of disease. However, the noncryopreserved group had a shorter hospital stay and entailed less cost than the cryopreserved group (8149$ against 8900$, respectively). This could be attributed to the fact that liquid nitrogen was not used, and the shorter hospital stay ( P = 0.000) lowered the cost for medications, laboratory tests, and procedures. Cryopreserved therapy was found to be cost-effective with regard to keeping the patient alive in those who cannot tolerate proceeding to autologous stem cell transplant immediately after mobilization. Conclusion Noncryopreserved therapy required a lesser number of aphaeresis sessions, was associated with a shorter hospital stay, was less costly than cryopreserved therapy, and it yielded the possibility of transplantation in patients with hepatitis without the need for buying a special liquid-nitrogen tank.