Abstract
Introduction: Autologus Stem Cell Transplant (ASCT) has found it’s place in the therapy of some common neoplastic diseases such as lymphoma, Hodgkin’s disease and multiple myeloma, and is still under research in a many other malignant and non-malignant diseases such as autoimmune disorders. One common problem for centers performing these procedures in the developing world is the remote possibility of acquiring the controlled-rate freezing and liquid Nitrogen storage apparatus.
Method: We have previously described a simple cryopreservation technique that does not require controlled-rate freezing nor liquid Nitrogen, and only utilizes common hospital equipment (Borbolla, et al. Blood 2000,96;11:1654a).
Results: Our group has performed 35 Autologus stem cell transplants in three different hospitals, using this cryopreservation method. All transplants were performed using peripheral blood stem cells obtained by apheresis. Mean CD34+ cell counts before cryopreservation were 2.72 X10^8 (SD:±1.07). Mean number of days between cryopreservation and transplant was 23.31 (SD:±15.66). Mean cell viability using Trypan blue method was 95%. One heavily treated and irradiated patient had engraftment failure. Mean number of days to neutrophil engraftment (ANC>500 cells/μL) was 14.55 (SD:±4.54); and for platelet engraftment (Plt>20,000/μL) was 23.18 (SD:±6.85).
Conclusion: Our cryopreservation method is comparable to other more expensive and cumbersome variants. Despite the fact that there is controversy surrounding some new indications for ASCT, some indications are already established and increase significantly the possibilities of a great number of patients to be cured from many malignant diseases such as NHL, Hodgkin’s disease, multiple myeloma, germ cell cancers and Ewing’s sarcoma, among others.
While there is no centralized data, the number of ASCT procedures performed in developing countries is known to be staggeringly low. The authors believe that behind these very low numbers, are economic issues and not professional capabilities of our health personnel. With the help of a Humanitarian Service Institution (Rotary International) we are currently working with a hospital in a Caribbean country to help them start performing ASCT using this cryopreservation method. Just as we did in our year 2000 meeting poster, we encourage Hematology departments in developing countries to get in touch with us (borbolla@itesm.mx) in order to arrange for this free technology transfer which will enable them to offer this procedure to their patients.
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