Hematopoietic cell infusion-related adverse events in pediatric/small recipients in a prospective/multicenter study.

Abstract:

BACKGROUND:Hematopoietic cell infusion-related adverse events (HCI-AEs) in hematopoietic stem cell transplantations (HSCTs) have been largely attributed to toxicity of dimethyl sulfoxide (DMSO) for cryopreservation, but HSC products also contain various cells and plasma components. Our recent prospective study of 1125 HSCT recipients revealed the highest overall HCI-AE rate in bone marrow transplantation (BMT) using fresh/noncryopreserved products, although products of peripheral blood stem cell transplantation and cord blood transplantation (CBT) are generally cryopreserved with DMSO containing smaller plasma volumes. We aimed to clarify if product volume and component effects are more substantial in small recipients including children. STUDY DESIGN AND METHODS:We performed subgroup analysis on 219 recipients of 45 kg or less body weight (whole small recipients), including 90 children (pediatric recipients), from the original cohort (general recipients). RESULTS:Whereas overall HCI-AE rates did not differ among hematopoietic stem cell sources in the general recipients, bradycardia most often occurred after CBT in whole small recipients. Conversely, whole small and general recipients shared the same trend of having the highest rate of hypertension in BMT. The overall HCI-AE rate was higher in allogeneic HSCT compared with autologous HSCT. Notably, pediatric recipients showed a 10-fold higher incidence of nausea and vomiting in allogeneic HSCT compared with autologous HSCT, suggesting a possible role of allogeneic antigens. Multivariate analysis identified a relatively large infusion volume per body weight as a significant factor correlating with HCI-AE in whole small recipients. CONCLUSIONS:We should be aware of product volume and specific HCI-AEs such as nausea and vomiting in small patients including children.

journal_name

Transfusion

journal_title

Transfusion

authors

Ikeda K,Ohto H,Yamada-Fujiwara M,Okuyama Y,Fujiwara SI,Muroi K,Mori T,Kasama K,Kanamori H,Iseki T,Nagamura-Inoue T,Kameda K,Kanda J,Nagai K,Fujii N,Ashida T,Hirose A,Takahashi T,Minakawa K,Tanosaki R

doi

10.1111/trf.15786

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

1015-1023

issue

5

eissn

0041-1132

issn

1537-2995

journal_volume

60

pub_type

临床试验,杂志文章,多中心研究
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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    journal_title:Transfusion

    pub_type: 临床试验,杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章,多中心研究

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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