Abstract
Toxicity related to autologous PBSC infusion is well known and traditionally attributed to the presence of DMSO as cryoprotectant. But despite DMSO depletion, adverse events continue appearing. We have conducted a retrospective study to determine the incidence of adverse events related to the PBSC infusion in a large series of 144 patients. Adverse effects were observed in 67.36% of patients, although most of them were of grade 1 or 2. The adverse events most frequently reported were allergic reactions, followed by general, gastrointestinal and respiratory symptoms. In the univariate analysis, age (P=0.01), the volume infused (P=0.005), the amount of DMSO (P=0.008), the total nucleated cells (P=0.002), the total number of granulocytes (P=0.000001) and clumping (P=0.000001) were associated with the occurrence of adverse events. In the multivariate analysis, two protective factors, age (P=0.05) and sex (P=0.004), and two risk factors, the number of granulocytes, with a relative risk of 1.18 (95% confidence interval, 1.06–1.31) (P=0.002), and clumping, with an relative risk of 1.94 (95% confidence interval, 1.15–3.29) (P=0.013), were identified. The best cutoff point for the prediction of the occurrence of adverse events, with a sensitivity of 47% and specificity of 89%, was 6.065 × 109 granulocytes.
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Kessinger A, Schmit-Pokorny K, Smith D, Armitage J . Cryopreservation and infusion of autologous peripheral blood stem cells. Bone Marrow Transplant 1990; 5: 25–27.
Rowley SD, MacLeod B, Heimfeld S, Holmberg L, Bensinger W . Severe central nervous system toxicity associated with the infusion of cryopreserved peripheral blood stem cell components. Cytotherapy 1999; 1: 311–317.
López-Jiménez J, Cerveró C, Muñoz A, Hernández-Madrid A, Fernández Pineda J, García Laraña J et al. Cardiovascular toxicities related to the infusion of cryopreserved grafts: results of a controlled study. Bone Marrow Transplant 1994; 13: 789–793.
Rowley SD, Feng Z, Yadock D, Holmberg L, MacLeod B, Heimfeld S . Post-thaw removal of DMSO does not completely abrogate infusional toxicity or the need for pre-infusion histamine blockade. Cytotherapy 1999; 1: 439–446.
Lemarie C, Calmels B, Malefant C, Arneodo V, Blaise D, Viret F et al. Clinical experience with the delivery of the thawed and washed autologous blood cells with an automated closed fluid management device: CytoMate. Transfusion 2005; 45: 737–742.
Bensinger W, Singer J, Appelbaum F, Lilleby K, Longin K, Rowley S et al. Autologous transplantation with peripheral blood mononuclear cells collected after administration or recombinant granulocyte stimulating factor. Blood 1993; 81: 3158–3163.
Hernandez-Navarro F, Ojeda E, Arrieta R, Rios-Rull P, Garcia-Bustos J, Quevedo E et al. Hematopoietic cell transplantation using plasma and DMSO without HES, with non-programmed freezing by immersion in a methanol bath: results in 213 cases. Bone Marrow Transplant 1998; 21: 511–517.
Beaujean F, Hartmann O, Kuentz M, Le Forestier C, Divine M, Duedari N . A simple, efficient washing procedure for cryopreserved human hematopoietic stem cells prior to reinfusion. Bone Marrow Transplant 1991; 8: 291–294.
Rodriguez L, Velasco B, Garcia J, Martin-Henao GA . Evaluation of an automated cell processing device to reduce the dimethyl sulfoxide from hematopoietic grafts after thawing. Transfusion 2005; 45: 1391–1397.
Syme R, Bewick M, Stewart D, Porter K, Chadderton T, Gluck S . The role of depletion of dimethyl sulfoxide before autografting: on hematologic recovery, side effects and toxicity. Biol Blood Marrow Transplant 2004; 10: 135–141.
Calmels B, Lemarie C, Esterni B, Malugani C, Charbonnier A, Coso D et al. Occurrence and severity of adverse events following autologous haematopoietic stem cell infusion is related to the amount of granulocytes in the apheresis product. Bone Marrow Transplant 2006; 37: abstract 906.
Rosskopf K, Wagner T, Schallmoser K, Eibl M, Brezinschek R, Linesch W et al. Clots in cryopreserved autologous peripheral blood stem cell concentrates at the time of thawing: possible causes and prophylactic strategies. Bone Marrow Transplant 1999; 29: abstract 7423.
Acknowledgements
We thank Mr Antonio Marcos and Ms Inmaculada Galindo for the technical support in the apheresis procedure, Mr Philip Bazire for his support in translation of the manuscript, and all doctors and nurses from the Bone Marrow Transplantation Unit for taking care of our patients. Translation has been financed by Amgen Oncology.
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Cordoba, R., Arrieta, R., Kerguelen, A. et al. The occurrence of adverse events during the infusion of autologous peripheral blood stem cells is related to the number of granulocytes in the leukapheresis product. Bone Marrow Transplant 40, 1063–1067 (2007). https://doi.org/10.1038/sj.bmt.1705861
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DOI: https://doi.org/10.1038/sj.bmt.1705861
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