Effect of Fresh versus Cryopreserved Grafts on Febrile Neutropenia and Infections in Allogeneic Hematopoietic Cell Transplantation: Factors Determining Mortality


Yalçın C., Orhan B., ERSAL T., Şentürk M., ÖZKOCAMAN V., AKALIN E. H., ...More

Mediterranean Journal of Hematology and Infectious Diseases, vol.18, no.1, 2026 (SCI-Expanded, Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 18 Issue: 1
  • Publication Date: 2026
  • Doi Number: 10.4084/mjhid.2026.032
  • Journal Name: Mediterranean Journal of Hematology and Infectious Diseases
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
  • Keywords: Allogeneic stem cell transplantation, Cryopreserved, Febrile neutropenia, Fresh
  • Kütahya Health Sciences University Affiliated: Yes

Abstract

Background: The study aimed to compare the incidence and course of febrile neutropenia (FN) and factors affecting mortality in hematologic patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) with either fresh or cryopreserved grafts. Methods: The clinical data of 155 patients who underwent allo-HSCT at our hematology clinic between 2010 and 2023 were retrospectively analyzed. The incidence of bloodstream infection (BSI) and FN-related mortality was analyzed in these patients. Factors affecting FN-related mortality were examined using a logistic regression model. Results: A total of 143 patients who developed FN were included in the study. Ninety-eight patients underwent transplantation with fresh stem cells, and 45 patients with cryopreserved stem cells. The duration of FN episodes was similar between groups (p = 0.077); however, the duration of deep neutropenia (neutrophils < 100/mm³) was significantly longer in the cryopreserved group (11.56 ± 4.84 vs. 7.78 ± 3.03; p < 0.001). GNB infections and invasive fungal infections were more frequent in the cryopreserved group (p = 0.009 and p < 0.001, respectively). In the logistic regression model, the most important determinants of FN-related mortality were duration of the FN episode (OR 1.18; 95% CI 0.99–1.41; p = 0.046) and higher hematopoietic cell transplantation comorbidity index (HCT-CI) score (score 1; p = 0.014 and score 2; p = 0.039). Conclusions: This study demonstrated that, regardless of graft type, prolonged FN duration and a high HCT-CI score are the primary determinants of mortality. Therefore, clinical management of patients should also address these risk factors.