Introduction: Recently, we identified a huge discrepancy between the collection practice and the actual utilization of cryopreserved peripheral blood stem cells (PBSCs) for high-dose chemotherapy (HDCT) and autologous blood stem cell transplantation (ABSCT). Specifically, patients with Burkitt lymphoma, acute leukemia, and myeloproliferative neoplasms (MPN) were frequently not referred for ABSCT after successful PBSC collection. Objective: The aim of this study was to identify variables that are associated with the non-utilization of PBSC grafts. Methods: We retrospectively analyzed the collection, storage, and disposal of PBSC grafts in Burkitt lymphoma (n = 18), acute lymphoblastic leukemia (ALL, n = 22), MPN (n = 18), and acute myeloid leukemia (AML, n = 71) patients. Patients who underwent autologous PBSC collection at 2 collection and transplantation centers between 2001 and 2012 were included and followed up until 2016. Results: None of the Burkitt lymphoma patients were referred for ABSCT. Only in 1 (6%) patient, the graft was discarded after the patient’s death. In all other patients (n = 17, 94%), the grafts were stored independently of the patient’s status (death, n = 4, 22%; no follow-up, n = 6, 33%; no indication for ABSCT given, n = 7, 39%). In ALL patients, 4 (18%) patients underwent ABSCT after a median follow-up of 74 (1–182) months. In the remaining patients, PBSC grafts were either discarded (8 patients, 36%) or stored until the reference date (10 patients, 45%). Seven of 18 MPN patients (39%) underwent ABSCT. ABSCT was performed in 24 (34%) AML patients. In 20 (28%) patients who were not referred to ABSCT, an allogeneic transplantation (TPL) was performed. Fifteen (21%) patients received palliative care or deceased, and their grafts were discarded in all but 1 patient. Additional grafts were discarded in 21 (31%) patients and stored in 9 (13%) patients who underwent ABSCT or allogeneic TPL (n = 44). Conclusions: As the role and efficacy of autologous HDCT/ABSCT are not established in the analyzed entities, the indication for PBSC collection should be reanalyzed in regular intervals. Moreover, PBSC grafts from patients who have deceased, have insufficient grafts, or have already undergone an allogeneic TPL should be considered for disposal or (if applicable) for research use, to economize storage costs on a rational basis.
Transfus Med Hemother

中文翻译：

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冷冻至什么目的？– Burkitt淋巴瘤，急性淋巴细胞白血病，急性髓样白血病和骨髓增生性肿瘤患者的自体干细胞产品

简介：最近，我们发现在大剂量化疗（HDCT）和自体血干细胞移植（ABSCT）中，冷冻保存的外周血干细胞（PBSC）的收集实践与实际利用之间存在巨大差异。具体而言，成功收集PBSC后，常不推荐Burkitt淋巴瘤，急性白血病和骨髓增生性肿瘤（MPN）患者进行ABSCT转诊。目的：本研究的目的是确定与未利用PBSC移植物有关的变量。方法：我们回顾性分析了Burkitt淋巴瘤（ n = 18），急性淋巴细胞白血病（ALL， n = 22），MPN（18岁）中PBSC移植物的收集，储存和处置。n = 18）和急性髓细胞性白血病（AML，n = 71）患者。纳入2001年至2012年期间在2个采集和移植中心接受过自体PBSC采集的患者，并对其进行随访，直到2016年。结果： Burkitt淋巴瘤患者均未接受ABSCT转诊。仅在1名患者中（6％），患者死亡后将其丢弃。在所有其他患者中（n = 17，94％），移植物的存储与患者的状况无关（死亡，n = 4，22 ％；无随访，n = 6，33％；未给予ABSCT指征，ñ= 7，39％）。在所有患者中，有74名（1–182）个月的中位随访后，有4名（18％）患者接受了ABSCT。在其余患者中，将PBSC移植物丢弃（8例，36％）或保存至参考日期（10例，45％）。18名MPN患者中有7名（39％）接受了ABSCT。在24名（34％）AML患者中进行了ABSCT。在20名（28％）未接受ABSCT的患者中，进行了同种异体移植（TPL）。15例（21％）患者接受了姑息治疗或已故，除1例患者外，其余患者均放弃了移植物。在接受ABSCT或同种异体TPL（n = 44）的21名患者（31％）中，其他的移植物被丢弃，而9名患者（13％）中的移植物被存储。结论：由于未在分析的实体中确定自体HDCT / ABSCT的作用和功效，因此应定期对PBSC收集的适应症进行重新分析。此外，应考虑将已故，移植物不足或已接受异体TPL的患者的PBSC移植物进行处置或（如果适用）用于研究用途，以合理地节省存储成本。
Transfus Med Hemother