Search

Autologous peripheral blood stem cell (PBSC) transplantation is a standard treatment of multiple myeloma (MM), Hodgkin lymphoma and various subtypes of non-Hodgkin lymphoma. Cryopreservation of hematopoietic stem cells is standard practice that allows time for delivery of conditioning regimen prior to cell infusion. The aim of this Worldwide Network for Blood & Marrow Transplantation (WBMT) work was to assess existing evidence on non-cryopreserved autologous transplants through a systematic review/meta-analysis, to study feasibility and safety of this approach. We searched PubMed, Web of Science and SCOPUS for studies that utilized non-cryopreserved autologous PBSC transplantation. Identified literature was reviewed for information on mobilization, apheresis, preservation and viability, conditioning regimen, engraftment, response, and survival. Results highlight collective experience from 19 transplant centers (1686 patients), that performed autologous transplants using non-cryopreserved PBSCs. The mean of infused CD34+ was 5.6 × 10 6 /kg. Stem cell viability at transplantation was >90% in MM and >75% in lymphomas, after a storage time of 24-144 h at +4 °C. Mean time-to-neutrophil engraftment was 12 days and 15.3 days for platelets. Pooled proportion estimates of day 100 transplant-related mortality and graft failure were 1% and 0%, respectively. Non-cryopreservation of apheresed autologous PBSCs appears feasible and safe., Competing Interests: Competing interests: MAB, DN, REF, DJW, SG, AR, AB, AH, YK, AK, TE, MM, WR declare no conflicts of interest MAK-D: declares research/grant from Bristol Myers Squibb, Novartis, and Pharmacyclics, and lecture/honoraria from Kite Pharma; LG: declares relationship with Bristol Myers Squibb, Sanofi, Janssen, Pfizer; IY-A: declares honoraria from Kite Pharma, Novartis and Bristol Myers Squibb; HG: declares speaker bureau and consultancy for Therakos, Gilead, Novartis, Stemline, Neovii, Sanofi, and Takeda; SOA: declares advisory board with Kite Pharma and Novartis, and speaker honoraria from Kite Pharma, Novartis, and Johnson & Johnson; CC: declares honoraria (personal and institutional) for lectures and advisory boards from Bristol Myers Squibb, Kite Pharma/Gilead, Janssen, Jazz, Novartis, and Miltenyi Biotec; SKH: declares educational/travel grants from Novartis, Pfizer, Janssen, Therakos, Vertex, MSD, Roche; UG: declares consultancy/Honoraria :Kite Pharma, Incyte, Astellas, Jazz,and Vor; NH: honoria from Janssen, Novartis, Takeda, Abbvie, Roche, Astellas, Bigene; AA: declares lecture-Advisor /honoraria from Kite Pharma, Novartis, Takeda and Janssen; MP: declares research with Bristol Myers Squibb, Janssen, Kite Pharma, Novartis, and consultancy for Bristol Myers Squibb, Novartis, and honoraria from Gilead; JS: declares consultancy for Sanofi and ADRx, honoraria from Sanofi, Alexion, AstraZeneca Rare Disease, Prevail Therapeutics (Eli–Lilly), Pfizer, Sobi Pharmaceuticals, and Novartis, advisory committees for Sanofi, AstraZeneca Rare Disease, Prevail Therapeutics (Eli–Lilly), Pfizer, Sobi Pharmaceuticals, Novartis, speaker bureau for Sanofi, AstraZeneca Rare Disease, Prevail Therapeutics (Eli–Lilly), Pfizer, Sobi Pharmaceuticals, Novartis; DMc: declares lecture/honoraria from GSK, Novartis, Abbvie. Research funding from Imago Biosciences; NW: declares speakers fees from BMS Celgene, Kite Gilead, Novartis, Pierre Fabre, Sanofi Genzyme, Therakos Mallinckrodt, Travel reimbursement from Jannsen, Pierre Fabre; RG: declares speaking honoraria from Biotest, Pfizer, Medac, Neovii and Magenta; YA: declares lecture/honoraria from Otsuka Pharmaceutical Co., Ltd, Chugai Pharmaceutical Co., Ltd., Novartis Pharma KK, Meiji Seika Pharma Co., Ltd, Janssen Pharmaceutical K.K., and consultancy fee from JCR Pharmaceuticals Co., Ltd and Kyowa Kirin Co., Ltd; MK: declares non-specified relationship with Kite Pharma, Takeda and Gilead; AS: declares honoraria from Takeda, Bristol Myers Squibb /Celgene, MSD, Janssen, Amgen, Novartis, Gilead Kite, Sanofi, Roche, Genmab, AbbVie, Jazz Pharmaceuticals, consultancy from Takeda, Bristol Myers Squibb/Celgene, Novartis, Janssen, Gilead, Sanofi, Genmab, AbbVie, speaker bureau for Takeda and Research support from Takeda; MA: declares lecture/honoraria from Kite Pharma and Vertex Pharma., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Nowadays, haploidentical hematopoietic cell transplantation (haplo-HCT) has been routinely used worldwide. However, this procedure is still rarely proposed in low- or middle-income countries. During the 13th annual harmonization workshops of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC), a designated working group has proposed recommendations on how to set up such a transplantation in these countries. This was based on a review of the literature and expert-opinion as well as the previously published workshop on haplo-HCT of SFGM-TC (2016). Haploidentical donors appear to be a first alternative to HLA-matched siblings since the access to unrelated donor international registries are limited for several countries. While the procedure has the advantage of immediate access to several potential donors and of low cost, Haplo-HCT should be performed only in centers with a good experience of HLA-matched related transplantation (>10/year). In the absence of an HLA-matched related donor, haplo-HCT should be offered to all patients who are candidate for allo-HCT. Transplantation modalities should follow the conventional procedures with post-transplant cyclophosphamide as GVHD prophylaxis. Conditioning can be myeloablative or not according to each case. Our recommendations are intended to be general in scope and applicable to the majority of allo-HCT centers in these countries. An evaluation at regular basis is needed to assess the feasibility and to improve results., (Copyright © 2024. Published by Elsevier Masson SAS.)

Management of acquired aplastic anemia (AA) in emerging countries depends on the means of prognostic stratification, treatment and logistics available. During the 13th annual harmonization workshop of the francophone Society of bone marrow transplantation and cellular therapy (SFGM-TC), a designated working group reviewed the literature in order to elaborate unified guidelines for allogeneic hematopoietic cell transplantation (Allo-HCT) in this disease. In terms of practice, the conclusions are as follows; The use of anti-tymocyte globuline (ATG) is mainly from rabbit and very little from horse. Access to bone marrow graft, total body irradiation, and the international unrelated donor registries is limited, which justifies the use of peripheral blood stem cells, chemotherapy-based conditioning, and related alternative donor. The workshop recommends matched sibling allo-HCT in all patients aged less than 40 years with acquired severe or very severe AA. For patients aged over than 40 years, or who lack an HLA-identical donor, treatment with the combination of cyclosporin, horse ATG, eltrombopag or cyclosporine, eltrombopag is recommended. If horse ATG and eltrombopag are not available, matched sibling allo-HCT may be indicated as first-line therapy in patients aged between 40-60 years, and good performance status. Although, in patients who have failed immunosuppressive treatments and thrombopoietin agonists, and in the absence of HLA-matched donor, a haplo-identical allo-HCT with modified Baltimore conditioning is recommended., (Copyright © 2024 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)