ABSTRACT
Using 753 collections from 426 adult haematology patients, we conducted a retrospective, analysis into the effects of overnight storage and nucleated cell counts (NCC) on viable, CD34+ (vCD34+) recovery and engraftment kinetics post autologous stem cell, transplant (ASCT) with peripheral blood stem cells (PBSC). There were significant, differences in vCD34 + recovery ( P < 0.01) after cryopreservation associated with, the fresh NCC of ≥ 300 × 10 6 /mL in products stored overnight, but no association, with time to platelet or neutrophil engraftment post-ASCT was observed for these, products. There was no association of vCD34+ numbers or engraftment kinetics with cryopreserved NCC with either below or greater than the local recommended concentration of 400 × 106 /mL of product. However, there was significant difference in engraftment kinetics in relation to the viable CD34+ dose given at ASCT, in relation to the time to early engraftment and the amount of platelet support given during the engraftment period post-ASCT. We conclude the vCD34+ dose at ASCT is of great importance to early engraftment kinetics and that NCC is an important factor during overnight storage, but not for cryopreservation of PBSC. In light of our findings, we recommend that apheresis products collected in a closed system can safely be stored undiluted overnight.
Subject(s)
Graft Survival , Hematopoietic Stem Cell Transplantation , Adult , Humans , Retrospective Studies , Transplantation, Autologous , Antigens, CD34 , Cryopreservation , Cell CountABSTRACT
BACKGROUND: Advances in outpatient and supportive care and increased pressure on hospital bed usage has led to the investigation of hospital in the home (HITH) management following autologous haematologous stem cell transplantation (AutoHSCT) for patients with multiple myeloma or lymphoma. DESIGN: The Newcastle Mater Hospital Haematology Unit together with the Mater Acute Care Community Service (MACCS) developed a protocol for HITH care following AutoHSCT. OUTCOMES: Clinical outcomes of the protocol were audited: 40% (13) of patients were suitable candidates for HITH care post transplantation. Of these 84.6% (11) were readmitted to the haematology unit within seven days of discharge from hospital. CONCLUSION: Our preliminary experience suggests that with adequate infrastructure support and rigorous patient selection this model of care is both safe and feasible.
