Clinical toxicity of cryopreserved circulating progenitor cells infusion.
BACKGROUND
We evaluated the infusion-related toxicity of cryopreserved autologous circulating progenitor cells transplanted in 22 patients receiving high dose chemotherapy and stem cells transplantation for malignancy.


METHODS
Progenitor cells were collected following mobilization with chemotherapy plus filgrastim and stored in liquid nitrogen in the presence of 10% dimethylsulfoxide (DMSO). Before infusion of the graft, patients were medicated with mannitol, hydrocortisone and clorphenamine. The amount of DMSO infused as well as the number of dead and damaged cells were evaluated as possible cause of toxicity.


RESULTS
Eleven patients (50%) experienced symptoms related to graft infusion, nausea and vomiting being the most common adverse events. Hypotension was documented in 3 patients (one of them developing transient bradycardia resolved with atropin administration) and one had hypertension with tachycardia. Other observed side effects were: chest tightness (2 pts), fever and chills (3 pts), associated with abdominal cramps (2 pts). 7 out of 8 (88%) patients infused with greater than 30 mL volume of DMSO experienced side-effects, the grade of toxicity being significantly less in those receiving lower amount (< 30 mL) of DMSO. Two out of 4 pts who received the highest number of dead cells (> 10 x 10(9)) developed toxicity.


CONCLUSIONS
In our experience the infusion of cryopreserved peripheral blood progenitors caused minor to moderate toxicity in most cases and, when present, side effects were observed only during infusion. The amount of DMSO present in the graft is related to the grade of toxicity.
Zambelli
A
A
Divisione di Oncologia Medica, IRCCS Fondazione S. Maugeri, Centro Medico di Pavia, Italy.
Poggi
G
G
Da Prada
G
G
Pedrazzoli
P
P
Cuomo
A
A
Miotti
D
D
Perotti
C
C
Preti
P
P
Robustelli della Cuna
G
G
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000628:therapy; D002470:Cell Survival; D015925:Cryopreservation / Q000379:methods; D003451:Cryoprotective Agents / Q000009:adverse effects*; D004121:Dimethyl Sulfoxide / Q000009:adverse effects*; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000473:pathology; D006801:Humans; D006973:Hypertension; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009325:Nausea; D009369:Neoplasms / Q000628:therapy*; D011994:Recombinant Proteins; D014182:Transplantation, Autologous; D014839:Vomiting
D000970:Antineoplastic Agents; D003451:Cryoprotective Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim; D004121:Dimethyl Sulfoxide