ArticleFrontiers in oncology2026
Comparison of non-cryopreserved and cryopreserved autologous hematopoietic stem cell transplantation among patients with myeloma: single-center experience.
Article in Frontiers in oncology, 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: Non-cryopreserved hematopoietic stem cells (NCP HSCs) may simplify autologous stem cell transplantation (ASCT) by avoiding cryopreservation and dimethyl sulfoxide exposure. We compared the clinical outcomes of NCP HSCs and cryopreserved HSCs (CP HSCs) in patients with multiple myeloma. Methods: This retrospective, single-center cohort study included 200 consecutive patients with multiple myeloma who underwent ASCT between 2014 and 2024: 147 received NCP HSCs, and 53 received CP HSCs. Preservation practices changed over time, and NCP HSC use increased from 46.6% during 2014-2019 to 94.6% during 2020-2024. The baseline characteristics were not fully balanced: patients receiving NCP HSCs were older (mean age 59.0 vs. 56.5 years), and bortezomib-thalidomide-dexamethasone (VTD) induction was more frequent in the NCP HSC group, whereas cyclophosphamide-thalidomide-dexamethasone (CTD) predominated in the CP HSC group, and the infused CD34 Results: The median time to engraftment was 12 days [interquartile range (IQR), 11-13; range, 9-24] with NCP HSCs and 12 days (IQR, 11-14; range, 10-22) with CP HSCs (Mann-Whitney U = 3239, p = 0.062). Median hospitalization was shorter with NCP HSCs [17 days (IQR, 14-20)] than with CP HSCs [23.5 days (IQR, 18-26); p < 0.001]. Transplant-related mortality was 3.4% and 5.7% (p = 0.528), and overall survival was comparable. Mucositis was more frequent in the NCP HSC group, whereas infectious complications did not differ significantly. In multivariable Cox analysis, the stem cell preservation method was not independently associated with progression-free survival (PFS) (adjusted HR, 1.44; 95% CI, 0.76-2.74; p = 0.262). Pre-transplant very good partial response (VGPR) compared with complete response (CR) was associated with a higher progression hazard (adjusted HR, 1.83; 95% CI, 1.10-3.04; p = 0.020), whereas maintenance therapy was associated with a lower progression hazard (adjusted HR, 0.48; 95% CI, 0.26-0.89; p = 0.020). Conclusion: Compared with CP HSC transplantation, NCP HSC transplantation provided comparable engraftment, transplant-related mortality, and overall survival and was associated with shorter hospitalization. Although PFS differed between the cohorts, multivariable analysis did not identify the stem cell preservation method as an independent predictor of PFS. These findings support NCP HSC transplantation as a feasible alternative when appropriate logistical conditions are available, while emphasizing the contribution of disease- and treatment-related factors to long-term outcomes. NCP HSCs represent an alternative for ASCT in multiple myeloma, although the retrospective design, temporal changes in practice, and baseline differences between the cohorts limit causal interpretation.
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