In addition to the risks posed by the virus, the COVID-19 pandemic brought travel restrictions and personal contact limitations that created significant roadblocks for getting needed cells from donors across the world to patients needing hematopoietic
cell transplants. Waiting until the roadblocks could be removed was not an option. Lives depended on timely transplants. We needed another option.
Among the lessons learned during the pandemic is that we must be able to pivot from standard operating procedures (SOPs). The National Marrow Donor Program turned to mandating use of frozen, or cryopreserved, allogeneic grafts from related and unrelated donors. This ensured that grafts were received at the treating center prior to starting the preparative regimen for transplant, a process that entails use of high dose chemotherapy and/or radiation therapy that requires immediate infusion of the lifesaving graft. Lack of a graft at the appropriate time can be a matter of life and death.
While this was a necessary step to help patients awaiting transplants, there was limited data to reassure clinicians and patients and their families that cryopreservation would not adversely affect transplant outcomes. We now have data to help alleviate those concerns.
According to an observational study using the Center for International Blood and Marrow Transplant Research (CIBMTR) Research Database at six months after transplant, using frozen cells had no negative effect on overall survival or the risk of primary graft failure. Clinical outcomes of 1,543 first-time post-hematopoietic cell transplants during the early months of the pandemic (March-August 2020) were compared to those of 2,499 patients who had fresh cells transplanted before the pandemic (March-August 2019).
While the results are limited to the first six months after transplant, the results suggest that frozen cells appear to be a safe, effective cell transplant option. It is important to follow this group of patients and subsequent cryopreservation graft patients to determine the ultimate impact of cryopreservation on outcomes. In the meantime, this data helps inform clinical decision-making and gives stakeholders confidence in the option.
In the bigger picture, this study highlights the importance of anticipating the next challenges that could compromise patient health and evaluating potential solutions to remove guesswork from the equation. The tens of thousands of patients who will need this treatment in the next decade are counting on it.
Learn more by reviewing a comprehensive analysis and description of the study.
Steven M. Devine, Michelle Kuxhausen, Stephen R. Spellman, Caitrin Bupp, Kwang-Woo Ahn, Heather E. Stefanski, Jeffery J Auletta, Brent R. Logan and Bronwen E. Shaw