Variable CD34+ recovery of cryopreserved allogeneic HPC products: transplant implications during the COVID-19 pandemic

Author:

Purtill Duncan12ORCID,Antonenas Vicki3,Chiappini Paul4,Tong Daochen3,O’Flaherty Elizabeth45,Bajel Ashish45,Kabani Karieshma6,Larsen Stephen67,Tan Suikeat8,Hutchins Cheryl9,Curtis David J.1011ORCID,Kennedy Glen A.9,Watson Anne-Marie12,Bai LiJun13,Greenwood Matthew713,Gottlieb David J.37,Hamad Nada814ORCID

Affiliation:

1. Fiona Stanley Hospital, Murdoch, WA, Australia;

2. PathWest Laboratory Medicine, Murdoch, WA, Australia;

3. Westmead Hospital, Sydney, NSW, Australia;

4. Peter MacCallum Cancer Centre, Melbourne, VIC, Australia;

5. The Royal Melbourne Hospital, Melbourne, VIC, Australia;

6. Royal Prince Alfred Hospital, Sydney, NSW, Australia;

7. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia;

8. St Vincent’s Hospital, Darlinghurst, NSW, Australia;

9. Royal Brisbane and Woman’s Hospital, Herston, QLD, Australia;

10. Alfred Health, Melbourne, VIC, Australia;

11. Australian Centre for Blood Diseases, Monash University, Melbourne, VIC, Australia;

12. Liverpool Hospital, Liverpool, NSW, Australia;

13. Royal North Shore Hospital, St Leonards, NSW, Australia; and

14. Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia

Abstract

Abstract Donor registries and transplantation societies recommend cryopreservation of unrelated donor hemopoietic progenitor cell (HPC) products before the recipient commences conditioning therapy to mitigate the donor and travel risks associated with the COVID-19 pandemic. However, little is known regarding the postthaw quality of such allogeneic products or the effect of precryopreservation storage and processing on these characteristics. We investigated the postthaw CD34+ cell recovery and viability of 305 allogeneic HPC products cryopreserved at 9 laboratories across Australia. Median postthaw CD34+ cell recovery was 76% and ranged from 6% to 122%. Longer transit time before cryopreservation, white cell count (WCC) during storage, and complex product manipulation before cryopreservation were independently associated with inferior postthaw CD34+ cell recovery. Longer precryopreservation transit time and WCC were also associated with inferior postthaw CD34+ cell viability. We conclude that although postthaw CD34+ cell recovery and viability of cryopreserved allogeneic HPC is generally acceptable, there is a significant risk of poor postthaw product quality, associated with prolonged storage time, higher WCC, and complex product manipulation precryopreservation. Awareness of expected postthaw recovery and practices that influence it will assist collection, processing, and transplant centers in optimizing outcomes for transplant recipients.

Publisher

American Society of Hematology

Subject

Hematology

Reference13 articles.

1. European Society for Blood and Marrow Transplantation. Coronavirus disease COVID-19: EBMT recommendations update April 21, 2020 Available at: https://www.ebmt.org/sites/default/files/2020-04/EBMT_COVID-19-guidelines_v.7.1%282020-04-21%29.pdf. Accessed 29 April 2020.

2. National Marrow Donor Program: BeTheMatch. Donor Product Cryopreservation: updated March 23, 2020. Available at: https://www.ebmt.org/sites/default/files/2020-04/EBMT_COVID-19-guidelines_v.7.1%282020-04-21%29.pdf. Accessed 29 April 2020.

3. Hamad N . Bone Marrow Transplant Society of Australia and New Zealand COVID19 Consensus Position Statement 15th April 2020. Available at: https://www.bmtsanz.org.au/bone-marrow-transplant-society-of-australia-and-new-zealand-covid19-consensus-position-statement-15th-april-2020/. Accessed 29 April 2020.

4. Influence of infused cell dose and HLA match on engraftment after double-unit cord blood allografts;Avery;Blood,2011

5. Dominant unit CD34+ cell dose predicts engraftment after double-unit cord blood transplantation and is influenced by bank practice;Purtill;Blood,2014

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