ArticleCureus2026
Non-cryopreserved Autologous Peripheral Blood Stem Cell Transplantation for Lymphoma in a Resource-Limited Setting: Feasibility, Engraftment Kinetics, and Early Outcomes From Kashmir, India.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background Autologous stem cell transplantation (ASCT) is a standard consolidation strategy for selected patients with relapsed or high-risk lymphoma, but access remains limited in many low- and middle-income regions because of the cost and infrastructure required for stem cell cryopreservation. Non-cryopreserved ASCT using fresh peripheral blood stem cells stored at 4°C may provide a practical alternative. Methods We retrospectively analyzed 11 consecutive patients with lymphoma who underwent non-cryopreserved ASCT at the Department of Medical Oncology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar. Peripheral blood stem cells were mobilized with granulocyte colony-stimulating factor (G-CSF) alone or G-CSF plus plerixafor, stored at 4°C, and infused after institutional modified BEAM conditioning. Primary endpoints were feasibility, CD34+ cell collection, neutrophil and platelet engraftment, early toxicities, and day +100 survival. Results The median age was 41 years (range, 22-58), and 9 patients (81.8%) were male. Diagnoses included classical Hodgkin lymphoma in 4 patients (36.4%) and non-Hodgkin lymphoma in 7 patients (63.6%). Stage III-IV disease was present in 8 patients (72.7%), and 9 patients (81.8%) were in complete remission before transplant. G-CSF plus plerixafor was used in 9 patients (81.8%). The median CD34+ cell dose collected was 5.5 × 10^6/kg (range, 3.6-13.5), with a median of 2 apheresis sessions (range, 1-2). All grafts were stored for 6 days at 4°C. Median neutrophil and platelet engraftment occurred on day 11 (range, 10-13) and day 12 (range, 10-18), respectively. Febrile neutropenia occurred in 10 patients (90.9%); grade 3-4 mucositis occurred in 6 patients (54.5%). Day +30 survival was 100%, and day +100 survival was 90.9%, with one transplant-related death. Conclusion Non-cryopreserved ASCT for lymphoma was feasible at SKIMS Srinagar, with adequate CD34+ cell collection, rapid engraftment, and acceptable early survival. Larger prospective studies with standardized graft-quality monitoring, longer follow-up, and cost-effectiveness analysis are needed.
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