# Hyperbaric oxygen to improve blood count recovery in Auto-HCT for myeloma

> **NIH NIH R37** · UNIVERSITY OF ROCHESTER · 2021 · $347,581

## Abstract

High-dose chemotherapy combined with autologous hematopoietic cell transplantation (Auto-HCT) is
considered a standard of care treatment in patients with multiple myeloma (MM). High-dose chemotherapy
results in mucosal damage, mucositis, and bone marrow (BM) ablation, leading to neutropenia, neutropenic
fever and infections which can result both in post-transplant morbidity and potential mortality. Therefore,
interventions shortening neutropenia following Auto-HCT are necessary to reduce such transplant-related
mortality and morbidity and to reduce the overall cost of Auto-HCT. These interventions should focus on
improving hematopoietic stem/progenitor cell (HSPC) BM homing, as HSPCs transplanted into the circulation
must cross the blood/BM endothelium barrier and lodge in the BM compartment (homing) before producing
mature and functional hematopoietic cells (engraftment). We previously have demonstrated that HSPC
exposure to erythropoietin (EPO) inhibits umbilical cord blood (UCB)-HSPC in vitro transmigration. In order to
improve HSPC homing, we investigated hyperbaric conditions to lower EPO prior to HSPC transplantation. In a
pilot clinical trial, we have shown that HBO therapy, given as a single treatment prior to UCB transplantation,
was well-tolerated, resulting in significant reduction in EPO levels from baseline, also with improvement in
median time to neutrophil and platelet recoveries. HBO therapy was shown to be very well tolerated in a
subsequent Auto-HCT pilot study. When comparing our HBO cohort patients with our historic controls, our
preliminary data indicate a significant reduction in time to neutrophil and platelet count recoveries. Also, HBO
patients had significantly less mucositis and required less transfusions. Biologically, we observed a positive
correlation between HBO-mediated reduction in EPO and time to neutrophil recovery in our HBO cohort. Early
absolute lymphocyte count (ALC) recovery, historically attributed to NK cell recovery stimulated by IL-15, was
observed in 76% of HBO patients, compared to ~50% historically. Based on our preliminary data, we
hypothesize that HBO therapy significantly reduces post-transplant EPO and, as a result, improves HSPC
engraftment as evidenced by improved time to neutrophil and platelet recoveries in MM patients undergoing
high-dose therapy and Auto-HCT. We also hypothesize that HBO therapy up-regulates IL-15 post-transplant
resulting in enhanced NK cell and ALC recoveries in MM patients undergoing Auto-HCT. To test our
hypotheses, we propose a phase II randomized clinical trial in which patients will or will not receive HBO
therapy. In this study, we will examine HBO effects on neutrophil, platelet, and early ALC recovery among
other clinical end points. We also will examine HBO effects on plasma EPO, IL-15, and on NK cell recovery as
a potential explanation for our findings. Results from this proposed trial will be used to calculate the sample
size and power for a future III trial de...

## Key facts

- **NIH application ID:** 10409855
- **Project number:** 4R37CA225791-04
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Omar Aljitawi
- **Activity code:** R37 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $347,581
- **Award type:** 4N
- **Project period:** 2018-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10409855

## Citation

> US National Institutes of Health, RePORTER application 10409855, Hyperbaric oxygen to improve blood count recovery in Auto-HCT for myeloma (4R37CA225791-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10409855. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*