Autologous SCT in Multiple Myeloma: To Cryopreserve or Not to Cryopreserve
Posted: Thursday, March 4, 2021
In patients with multiple myeloma, autologous stem cell transplantation (SCT) using a noncryopreserved method seems effective and safe compared with the cryopreservation method. In fact, disease response at the time of autologous SCT and afterward at day +100—as well as progression-free and overall survival—were similar in both groups, according to Lalita Norasetthada, MD, of Chiang Mai University, Thailand, and colleagues.
In this study, published in the Annals of Transplantation, a total of 42 patients underwent autologous SCT. Of them, 26 patients and 16 patients underwent noncryopreservation and cryopreservation stem cell collections, respectively. There was no difference reported in the time to neutrophil engraftment (median, 12 vs. 10.5 days) or platelet engraftment (median, 14 vs. 12 days) between the groups. In addition, the incidence of infusion reactions and the duration of hospitalization was similar in both groups. The average cost of using the cryopreservation stem cell method was 10% lower than the noncryopreserved approach. There was no difference in progression-free survival (median, 16 vs. 22 months) or overall survival between the two study groups.
Regarding long-term outcomes, disease response at the time of autologous SCT and the time after autologous SCT at day +100 were similar in both groups. Consolidation and maintenance therapies were given to six patients in the noncryopreserved preservation group and five patients in the cryopreservation group.
Of note, the researchers were aware of the possibility of mucositis, a well-known adverse effect of high-dose melphalan conditioning. To remedy this, they provided ice chips to patients before and during treatment. They observed a low incidence of severe oropharyngeal mucositis. However, grade 3 to 4 gastrointestinal mucositis was reported in approximately 85% of both groups.
“The noncryopreserved method is less expensive and less time-consuming since stem cell collection can be performed before transplantation in the same admission,” the authors concluded.
Disclosure: The study authors reported no conflicts of interest
