ArticleJournal of blood medicine2026
Cryopreserved versus Fresh Stem Cell Grafts in Autologous Transplantation for Multiple Myeloma: Impact on Early Toxicity and Engraftment.
Article in Journal of blood medicine, 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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14 authors.
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Abstract
Introduction: Autologous hematopoietic stem cell transplantation (ASCT) remains a cornerstone therapy for eligible patients with multiple myeloma. Cryopreservation of hematopoietic grafts provides logistical flexibility but may increase procedure-related toxicity and resource utilization. Methods: We conducted a two-phase, non-randomized binational study at tertiary centers in Santiago, Chile, and Seville, Spain, comparing cryopreserved and non-cryopreserved grafts in patients undergoing ASCT. In the retrospective phase (2018-2023), outcomes were analyzed in 284 recipients of cryopreserved grafts and 148 recipients of non-cryopreserved grafts. In the prospective phase (2023-2025), 16 patients receiving cryopreserved grafts and 25 receiving non-cryopreserved grafts were evaluated for clinical endpoints and inflammatory biomarkers. Results: Recipients of non-cryopreserved grafts achieved faster neutrophil engraftment (median 11 vs 14-15 days) and shorter hospital stays (median 13 vs 18 days), with reduced rates of febrile neutropenia (19% vs 50%) and grade ≥3 mucositis (19% vs 60%). No early mortality occurred in either group. Cryopreserved grafts were associated with higher levels of selected inflammatory and endothelial-associated biomarkers, including IL-8 and VEGF-D, whereas non-cryopreserved grafts showed a distinct inflammatory profile, including a non-statistically significant trend toward higher IFN-γ levels at the time of transplantation. Discussion: Overall, the use of non-cryopreserved grafts was associated with reduced early transplant-related toxicity and comparable engraftment outcomes. Given the non-randomized design and center-specific supportive care practices, these findings should be interpreted as real-world associations and support further prospective evaluation of graft preservation strategies in autologous transplantation for multiple myeloma.
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