FRESH VERSUS CRYOPRESERVED AUTOLOGOUS STEM CELL INFUSION IN MULTIPLE MYELOMA: HEMATOLOGIC OUTCOMES AND ECONOMIC IMPACT
- 1Centro de Processamento Celular do Centro de Transplante de Medula Óssea do Instituto Nacional de Câncer (CPC/CEMO/INCA), Rio de Janeiro, RJ, Brazil
Abstract
Introduction: Cryopreservation of autologous hematopoietic stem cells is standard practice in autologous transplantation, but it is associated with additional costs, infrastructure requirements, and exposure to dimethyl sulfoxide. Fresh infusion represents a potentially simpler and more cost-effective alternative, although its use remains limited in contemporary practice. Objective: To compare hematologic outcomes and economic impact of fresh versus cryopreserved autologous stem cell infusion in patients with multiple myeloma undergoing autologous transplantation. Methods: This retrospective study included patients with Multiple Myeloma who underwent autologous transplantation using leukapheresis products between 2023 and 2025. Patients were divided into two groups: fresh infusion (n = 14) and cryopreserved (n = 7). The primary endpoint was time to neutrophil engraftment. Variables related to cellular product quality, including CD34-positive cell dose and total nucleated cell count, were analyzed. Statistical analysis included Mann–Whitney test and time-to-event analysis using Kaplan–Meier curves and the Cox proportional hazards model. Economic analysis considered direct, operational, and indirect costs associated with cryopreservation, with estimation of cost savings per patient. Results: There was no significant difference in time to neutrophil engraftment between groups, with a median of 10 days in the fresh group and 11 days in the cryopreserved group (p = 0.209). Kaplan–Meier curves were overlapping, showing no evidence of delayed engraftment with fresh infusion. In Cox analysis, product type was not associated with time to engraftment, with a hazard ratio of 1.65 and a wide confidence interval. A trend toward higher CD34-positive cell dose was observed in the fresh group (median 4.27 vs 3.45 × 10⁶/kg). Cryopreservation was associated with additional costs estimated between USD 1,400 and 3,000 per patient, resulting in overall savings between USD 19,000 and 40,000 in the analyzed cohort. Conclusion: Fresh autologous stem cell infusion was not inferior to cryopreservation regarding neutrophil engraftment and showed no negative impact on hematologic outcomes. Additionally, it represents a high-value strategy, with substantial cost reduction, elimination of dimethyl sulfoxide exposure, and simplified logistics.
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BibTeX
@article{braga2026fresh,
title = {{FRESH VERSUS CRYOPRESERVED AUTOLOGOUS STEM CELL INFUSION IN MULTIPLE MYELOMA: HEMATOLOGIC OUTCOMES AND ECONOMIC IMPACT}},
author = {Flavio Henrique Paraguassú BRAGA and Pedro Felipe Couto VIEIRA and Juliaana Jardim SALDANHA and Simone Dias Gonçalves DOS PASSOS and Luciglei Nazareth BAIENSE and Adriano Bayão da Rocha SILVA and Décio LERNER},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.106872},
url = {https://doi.org/10.1016/j.htct.2026.106872},
note = {CC BY},
}
RIS
TY - JOUR
TI - FRESH VERSUS CRYOPRESERVED AUTOLOGOUS STEM CELL INFUSION IN MULTIPLE MYELOMA: HEMATOLOGIC OUTCOMES AND ECONOMIC IMPACT
AU - Flavio Henrique Paraguassú BRAGA
AU - Pedro Felipe Couto VIEIRA
AU - Juliaana Jardim SALDANHA
AU - Simone Dias Gonçalves DOS PASSOS
AU - Luciglei Nazareth BAIENSE
AU - Adriano Bayão da Rocha SILVA
AU - Décio LERNER
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.106872
UR - https://doi.org/10.1016/j.htct.2026.106872
AB - Introduction: Cryopreservation of autologous hematopoietic stem cells is standard practice in autologous transplantation, but it is associated with additional costs, infrastructure requirements, and exposure to dimethyl sulfoxide. Fresh infusion represents a potentially simpler and more cost-effective alternative, although its use remains limited in contemporary practice. Objective: To compare hematologic outcomes and economic impact of fresh versus cryopreserved autologous stem cell infusion in patients with multiple myeloma undergoing autologous transplantation. Methods: This retrospective study included patients with Multiple Myeloma who underwent autologous transplantation using leukapheresis products between 2023 and 2025. Patients were divided into two groups: fresh infusion (n = 14) and cryopreserved (n = 7). The primary endpoint was time to neutrophil engraftment. Variables related to cellular product quality, including CD34-positive cell dose and total nucleated cell count, were analyzed. Statistical analysis included Mann–Whitney test and time-to-event analysis using Kaplan–Meier curves and the Cox proportional hazards model. Economic analysis considered direct, operational, and indirect costs associated with cryopreservation, with estimation of cost savings per patient. Results: There was no significant difference in time to neutrophil engraftment between groups, with a median of 10 days in the fresh group and 11 days in the cryopreserved group (p = 0.209). Kaplan–Meier curves were overlapping, showing no evidence of delayed engraftment with fresh infusion. In Cox analysis, product type was not associated with time to engraftment, with a hazard ratio of 1.65 and a wide confidence interval. A trend toward higher CD34-positive cell dose was observed in the fresh group (median 4.27 vs 3.45 × 10⁶/kg). Cryopreservation was associated with additional costs estimated between USD 1,400 and 3,000 per patient, resulting in overall savings between USD 19,000 and 40,000 in the analyzed cohort. Conclusion: Fresh autologous stem cell infusion was not inferior to cryopreservation regarding neutrophil engraftment and showed no negative impact on hematologic outcomes. Additionally, it represents a high-value strategy, with substantial cost reduction, elimination of dimethyl sulfoxide exposure, and simplified logistics.
SN - 2531-1379
SN - 2531-1387
ER -