Hematopoietic cell infusion-related adverse events in pediatric/small recipients in a prospective/multicenter study.
Adolescent
Adult
Age Factors
Aged
Body Weight
/ physiology
Bone Marrow Transplantation
/ adverse effects
Child
Child, Preschool
Cohort Studies
Cryopreservation
/ methods
Cryoprotective Agents
/ adverse effects
Dimethyl Sulfoxide
/ adverse effects
Female
Hematopoietic Stem Cell Transplantation
/ adverse effects
Hematopoietic Stem Cells
Humans
Infant
Infant, Newborn
Male
Middle Aged
Peripheral Blood Stem Cell Transplantation
/ adverse effects
Transfusion Reaction
/ epidemiology
Transplantation, Homologous
/ adverse effects
Young Adult
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
14
08
2019
revised:
02
02
2020
accepted:
03
03
2020
pubmed:
20
4
2020
medline:
9
9
2020
entrez:
20
4
2020
Statut:
ppublish
Résumé
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. 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). 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. We should be aware of product volume and specific HCI-AEs such as nausea and vomiting in small patients including children.
Sections du résumé
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.
Substances chimiques
Cryoprotective Agents
0
Dimethyl Sulfoxide
YOW8V9698H
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1015-1023Subventions
Organisme : Japan Society of Transfusion and Cell Therapy
Pays : International
Organisme : Ministry of Health, Labour and Welfare
Pays : International
Informations de copyright
© 2020 AABB.
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