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Assessing deviations for HPCs obtained during COVID-19 (ADHOC): Evaluating impact of the COVID-19 pandemic on
Suzanne R Thibodeaux1, Dean Coble2, Victoria Day3
1Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA.
Insights
Routine cryopreservation of allogeneic hematopoietic stem cell (HSC) donations did not significantly impact product quality or transplant outcomes, though a slight delay in neutrophil engraftment was observed.
Area of Science:
- Hematology
- Transplantation Immunology
- Cellular Therapy
Background:
- Allogeneic hematopoietic stem cell transplantation (HSCT) relies on fresh cell donations delivered via a just-in-time model.
- The COVID-19 pandemic disrupted logistics, prompting recommendations for cryopreservation of stem cell products.
- This shift aimed to prevent interruptions in patient treatment during the pandemic.
Purpose of the Study:
- To evaluate the impact of routine cryopreservation on allogeneic stem cell donation characteristics.
- To assess potential differences in transplant outcomes before and after implementing cryopreservation.
Main Methods:
- A survey of nine international laboratories was conducted.
- Data from 72 donations before cryopreservation and 71 after were analyzed.
- Key parameters included product transit time, temperature, CD34+ cell viability, and neutrophil engraftment time.
Main Results:
- No significant differences were found in product transit time, temperature at receipt, or CD34+ cell viability.
- A trend towards slower absolute neutrophil count recovery was observed after cryopreservation (15 days vs. 17.6 days).
Conclusions:
- Routine cryopreservation of allogeneic HSC products appears safe regarding product quality and most transplant parameters.
- Further investigation is warranted for the observed trend of delayed neutrophil engraftment in larger, long-term studies.
Background:
The success of allogeneic hematopoietic stem cell transplantation is dependent on a world-wide network of collection centers providing donations that predominantly have been infused as fresh cells. The logistics chain that supports the just-in-time delivery model for stem cell and immunotherapy products was severely stressed by the COVID pandemic, and in early 2020 a number of national and international bodies recommended that cells should be cryopreserved at the collection or transplant center to avoid interruptions in their acquisition or delivery to patients who had started conditioning.
Study Design:
To assess the potential consequences of such pandemic-related deviations to normal practice, we surveyed nine international laboratories to determine if the characteristics or transplant outcomes of allogeneic stem cell donations differed in the immediate periods before and after the switch to routine cryopreservation.
Results:
Nine centers on two continents provided data for 72 HSC donations just before, and 71 just after, switching to cryopreservation for allogeneic HSC products. No statistically significant differences between the period before and after cryopreservation were noted for time from product collection to receipt, product temperature at receipt, or CD34+ cell viability at receipt. There was an indication of slower absolute neutrophil count recovery after cryopreservation was required (mean time of 15 vs. 17.6 days).
Discussion:
While there were no apparent changes to most parameters studied, there was an indication of slower neutrophil engraftment that will need to be examined in larger, longer term studies.
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