PMID- 28301051
OWN - NLM
STAT- MEDLINE
DCOM- 20170919
LR  - 20180302
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 57
IP  - 6
DP  - 2017 Jun
TI  - Adverse events of cryopreserved hematopoietic stem cell infusions in adults: a 
      single-center observational study.
PG  - 1522-1526
LID - 10.1111/trf.14072 [doi]
AB  - BACKGROUND: Autologous hematopoietic stem cell (HSC) transplantation has been 
      used for almost three decades for the management of malignant hematologic 
      diseases and some solid tumors. Dimethyl sulfoxide (DMSO) is used as a 
      cryoprotective agent for hematopoietic progenitor cells (HPCs) collected by 
      apheresis (HPC-A). We evaluated the factors contributing to the occurrence of 
      adverse events (AEs) of cryopreserved HPC-A infusion. STUDY DESIGN AND METHODS: 
      Between January 2009 and June 2014, a total of 1269 (1191 patients) consecutive 
      HPC-A infusions were given to adult patients undergoing autologous HSC 
      transplantation at Barnes-Jewish Hospital. Only infusions on the first day of 
      transplant were included in the analysis. RESULTS: AEs were reported in 480 
      (37.8%) infusions. The most common AEs were facial flushing in 189 (39.4%) 
      infusions, nausea and/or vomiting in 183 (38.1%) infusions, hypoxia requiring 
      oxygen in 139 (29%) infusions, and chest tightness in 80 (16.7%) infusions. 
      Multivariate analysis using logistic regression showed that female sex (odds 
      ratio [OR], 1.78; 95% confidence interval [CI], 1.40-2.26; p < 0.0001), diagnosis 
      other than multiple myeloma (OR, 1.44; 95% CI, 1.12-1.84; p = 0.004), larger 
      volume of infusion per body weight (OR, 1.66; 95% CI, 1.29-2.15; p < 0.0001), and 
      number of granulocytes infused per body weight (OR, 1.30; 95% CI, 1.01-1.67; 
      p = 0.042) were significant predictors of occurrence of AEs during infusion. 
      CONCLUSION: AEs due to HPC-A infusion occurred in more than one-third of 
      patients. Interventions need to be instituted to reduce AEs and thus improve the 
      safety of HPC-A infusion. Many of these toxicities can be attributed to DMSO, and 
      this is reflected in the volume of infusion. It might be warranted to consider 
      implementing DMSO-reducing protocols before infusion.
CI  - (c) 2017 AABB.
FAU - Otrock, Zaher K
AU  - Otrock ZK
AD  - Department of Pathology and Immunology, Barnes-Jewish Hospital, Washington 
      University, St Louis, Missouri.
FAU - Sempek, Diane S
AU  - Sempek DS
AD  - Department of Pathology and Immunology, Barnes-Jewish Hospital, Washington 
      University, St Louis, Missouri.
FAU - Carey, Sherry
AU  - Carey S
AD  - Department of Pathology and Immunology, Barnes-Jewish Hospital, Washington 
      University, St Louis, Missouri.
FAU - Grossman, Brenda J
AU  - Grossman BJ
AD  - Department of Pathology and Immunology, Barnes-Jewish Hospital, Washington 
      University, St Louis, Missouri.
LA  - eng
PT  - Journal Article
DEP - 20170316
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
RN  - 0 (Cryoprotective Agents)
RN  - YOW8V9698H (Dimethyl Sulfoxide)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cryopreservation/*methods
MH  - Cryoprotective Agents/*adverse effects
MH  - Dimethyl Sulfoxide/adverse effects
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects
MH  - Hematopoietic Stem Cells/*drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Transplantation, Autologous/*adverse effects
MH  - Young Adult
EDAT- 2017/03/17 06:00
MHDA- 2017/09/20 06:00
CRDT- 2017/03/17 06:00
PHST- 2016/10/20 00:00 [received]
PHST- 2017/01/04 00:00 [revised]
PHST- 2017/01/13 00:00 [accepted]
PHST- 2017/03/17 06:00 [pubmed]
PHST- 2017/09/20 06:00 [medline]
PHST- 2017/03/17 06:00 [entrez]
AID - 10.1111/trf.14072 [doi]
PST - ppublish
SO  - Transfusion. 2017 Jun;57(6):1522-1526. doi: 10.1111/trf.14072. Epub 2017 Mar 16.