Adverse events after infusions of cryopreserved hematopoietic stem cells depend on non-mononuclear cells in the infused suspension and patient age.
BACKGROUND
Adverse events (AE) represent a significant clinical problem after infusion of cryopreserved HPC. However, the factors playing a role in the pathogenesis have not yet been fully established.


METHODS
We prospectively collected data on AE that occurred with 179 HPC infusions performed on patients affected with hematologic neoplasm after high-dose chemotherapy. The stem cell source was hemopoietic progenitor cells aphaeresis (HPC-A) in 157 cases and hemopoietic progenitor cell BM (HPC-BM) in 22 cases. In all cases, an endotoxin-free DMSO was used.


RESULTS
One or more AE were registered in 51/179 infusions (28.6%). The frequency of AE was higher after HPC-A than after HPC-BM (31.3% vs. 4.5%; chi(2) test, P =0.008). With univariate logistic regression, other factors found important for AE were age (P =0.028), number of total nucleated cells infused per kilogram (P =0.002), volume per kilogram infused (P =0.057), volume of packed RBC (P =0.019), a content of non-mononuclear cells >0.5 x 10(8)/kg (<P =0.0001) and actual time of infusion (P =0.058). When all aforementioned factors were evaluated with a multivariate logistic regression, only age of patient (P =0.024) and a content of non-mononuclear cells >0.5 x 10(8)/kg (P =0.0003) remained significant. A significant correlation existed between reduction of cardiac frequency both with volume per kilogram infused (r =0.221, P =0.02) and actual time of infusion (r =0.269, P =0.005).


CONCLUSIONS
Cardiovascular changes are influenced by volume per kilogram infused and by actual time of infusion, while non-cardiovascular AE are dependent on patient age and contamination by non-mononuclear cells in apheretic harvests.
Milone
G
G
Division of Haematology and BM Transplantation, Ospedale Ferrarotto, Catania, Italy. guwgim@tin.it
Mercurio
S
S
Strano
A
A
Leotta
S
S
Pinto
V
V
Battiato
K
K
Coppoletta
S
S
Murgano
P
P
Farsaci
B
B
Privitera
A
A
Giustolisi
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D001781:Blood Component Removal; D001794:Blood Pressure; D001854:Bone Marrow Cells / Q000166:cytology; D002319:Cardiovascular System; D002648:Child; D015925:Cryopreservation; D005260:Female; D006339:Heart Rate; D006400:Hematocrit; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007963:Leukocytes, Mononuclear; D008297:Male; D008875:Middle Aged
D007770:L-Lactate Dehydrogenase