CD34+ Hematopoietik Kök Hücrelerin Cryofit® DMSO Kullanılarak Kriyoprezervasyonu ve Sonuçları

Öz

Amaç: Otolog hematopoetik kök hücre nakli (OKHN), hematolojik maligniteler ve immün bozukluklar için önemli bir tedavi yöntemidir. CD34+ hematopoetik kök hücrelerin (HKH) kriyoprezervasyonu, nakil başarısını sağlamak için kritik bir adımdır. Dimetil sülfoksit (DMSO), yaygın olarak kullanılan bir kriyoprotektandır ancak infüzyona bağlı toksisiteler oluşturabilir. CryoFit® DMSO, hücre canlılığını artırmayı ve olumsuz etkileri azaltmayı amaçlamaktadır. Bu çalışma, DMSO ile kriyoprezervasyonun OKHN’de etkinliğini ve güvenliğini değerlendirmektedir. Gereç ve Yöntem: Bu çalışma, tek merkezli retrospektif bir analiz olup daha önceden CryoFit® DMSO ile kriyoprezervasyon yapılmış kök hücrelerden OKHN olan 80 hasta dahil edildi. Kök hücre mobilizasyonu, granülosit koloni stimüle edici faktör (G-CSF) ± kemoterapi ve gerekli durumlarda plerixafor kullanılarak gerçekleştirilmiştir. CD34+ hücreleri kriyoprezervasyondan önce akış sitometrisi ile sayıldı. Nakil sonrası kök hücre yamanması (engraftment), transfüzyon ihtiyacı ve infüzyona bağlı yan etkiler değerlendirildi. Veri analizi SPSS 26.0 yazılımı ile yapıldı. Bulgular: Hastaların medyan yaşı 58.5 (aralık: 19-75), ve kohortun %53,8’i kadındı. En yaygın tanı multipl miyelomdu (%57,5). Toplanan CD34+ hücrelerin medyan miktarı 5.8 x 106/kg (aralık: 3.2-14) idi. Çözündürme sonrası hücre canlılığı %98 (aralık: %90-99.5) olarak bulundu. Nötrofil ve trombosit engraftmanı sırasıyla medyan 13 ve 17 gün olarak izlendi. Medyan hastanede kalış süresi 24 gün (aralık: 15-60) idi. Hastaların %26,3’ünde infüzyona bağlı yan etkiler gözlendi, en yaygın olanı bulantı/kusmaydı (%15) ve tüm yan etkiler yönetilebilir düzeydeydi. Sonuç: CryoFit® DMSO, CD34+ HKH’ların çözündürme sonrası yüksek canlılık oranları ile etkin bir şekilde korunmasını sağlamıştır. Hafif infüzyona bağlı toksisiteler gözlemlenmiş ancak geçici olmuştur. Bu sonuçlar, CryoFit® DMSO’nun OKHN’de kullanımını desteklemektedir. Kriyoprezervasyon protokollerini optimize etmek için çok merkezli ileri çalışmalar gereklidir.

Anahtar Kelimeler

• Dimetil sülfoksit
• hematopoetik kök hücre transplantasyonu
• kriyoprezervasyon
• dimetil sülfoksit
• mobilizasyon
• engrafman

Cryopreservation of CD34+ Hematopoietic Stem Cells Using Cryofit® DMSO and Its Outcomes

Öz

Objective: Autologous hematopoietic stem cell transplantation (auto-SCT) is a key treatment for hematological malignancies and immune disorders. Cryopreservation of CD34+ hematopoietic stem cells (HSCs) ensures transplant success. Dimethyl sulfoxide (DMSO) is a widely used cryoprotectant but can cause infusion-related toxicities. CryoFit® DMSO aims to enhance cell viability while reducing adverse effects. This study evaluates its efficacy and safety in auto-SCT. Material and Method: A single-center, retrospective study was conducted on 80 patients who underwent auto- SCT with CD34+ HSCs cryopreserved using CryoFit® DMSO. Mobilization was performed using granulocyte colony-stimulating factor (G-CSF) ± chemotherapy and plerixafor when required. CD34+ cells were quantified via flow cytometry before cryopreservation. Post-transplant engraftment, transfusion needs, and infusion-related side effects were assessed. Data analysis was conducted using SPSS 26.0. Results: The median patient age was 58.5 years (range: 19-75) and 53.8% (n=43) of the cohort sample was female. Multiple myeloma was the most common diagnosis (57.5%). The median collected CD34+ cell count was 5.8 x 106/ kg (range: 3.2-14). Post-thaw viability was 98% (range: 90-99.5%). Neutrophil and platelet engraftment occurred at medians of 13 and 17 days, respectively. The median hospitalization duration was 24 days (range: 15-60). Infusion-related adverse effects occurred in 26.3% of patients, primarily nausea/vomiting (15%), all manageable. Conclusion: CryoFit® DMSO effectively preserves CD34+ HSCs with high post-thaw viability and favorable engraftment. Mild infusion-related toxicities were observed but were transient. The results support its continued use in auto-SCT. Further multicenter studies are required to optimize cryopreservation protocols.

Anahtar Kelimeler

• Cryopreservation
• dimethyl sulfoxide
• engraftment
• hematopoietic stem cell transplantation
• mobilization

Etik Beyan

Approval for the study was obtained from the Dokuz Eylül University Non-Interventional Research Ethics Committee on 06/12/2023. Decision no: 2023/39-12.

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