Autologous Bone Marrow Transplantation - Blog Science Connections

Peripheral Stem Cell Transplantation 617
Cryopreservation of Apheresis-Derived Stem Cells
The 200-ml cell suspension collected per run was concentrated to 100
ml and mixed with the same volume of Spinner-minimum essential medium
supplemented with 20% dimethyl sulfoxide. The final 200-ml cell suspension
was distributed into two 100-ml polyolefine bags (DELMED, Canton, MA) and
frozen to -100°C in a computerized freezer (CRYOSON BV-6, Cryoson
Deutschland GmbH, Schollkrippen, West Germany). The frozen cells were
stored in the liquid phase of nitrogen until use.
Thawing and Transplanting Apheresis-Derived Stem Cells
The frozen bags were thawed by immersing them into a 40°C water bath.
The cell suspension was immediately injected into the patient using a central
line. Postthaw washing and spinning of cells was avoided to minimize the risk
of cell clumping and stem cell loss. The total volume of cell suspension
injected into the patient was in the range of 1500 ml and was given over 2
hours. Forced diuresis was started after infusing 500 ml. The transfusion of
the remaining free hemoglobin transiently impaired renal function (creatinine
was raised to 2.0-2.5 mg/dl for 24-48 hours). In our experience this
procedure produced no major risk to the patient, nor did the infusion of a
cooled 6°C-8°C cell suspension into the right atrium of the heart cause any
cardiac arrhythmia.
Regimen 1
Pretransplant Conditioning Regimens
Total body irradiation (TBI) using a linear accelerator, superfractionated
over 4 days at 120 cGy single dose up to a total of 1320-1440 cGy (lungs, 900
cGy). Three single doses were administered per day at 8 AM., noon, and 4 P.M..
Following TBI, cyclophosphamide (50 mg/kg) was given on each of 4
consecutive days (total dose 200 mg/kg) (patients 1, 3, and 6).
Regimen 2
TBI, superfractionated over 3 days up to a total of 1200 cGy, followed by a
single dose of melphalan (120 mg/m 2 ) (patient 4).
Regimen 3
Cyclophosphamide (1.5 g/m 2
x 4), carmustine (300 mg/m 2 ), and
etoposide (125 mg/m 2 x 3) (CBV regimen [22]) (patient 2).
Regimen 4
Mitoxantrone (12 mg/m 2
x 2 days), carmustine (300 mg/m 2 ), and
etoposide (125 mg/m 2 x 3 days) (patient 5).