Acute life-threatening cardiovascular toxicity with umbilical cord blood infusion: the role of dextran.
Umbilical cord blood (UCB) is being increasingly used for hematopoietic stem cell transplantation due to its immediate availability. Dimethylsulfoxide (DMSO) and dextran-40 are commonly used for processing and cryopreservation of UCB. Adverse UCB infusion-related events are usually mild. However, reports of severe life-threatening events are now emerging. DMSO has been proposed as a possible cause of infusion-related reactions. In this report, we draw attention to an acute near-fatal reaction with UCB infusions resulting in myocardial ischemia and acute renal failure. We propose that dextran-40 in UCB infusion products be considered as a potential causative agent contributing to this infusion-related reaction, based on reports of known adverse reactions to dextran-40 in non-transplant settings.
Ma
Robert W
RW
Kwan
John M
JM
Ma
David D
DD
Fay
Keith C
KC
D000328:Adult; D000368:Aged; D036101:Cord Blood Stem Cell Transplantation; D003911:Dextrans / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000139:chemically induced*; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000009:adverse effects*; D014184:Transplantation, Homologous
D003911:Dextrans; D010952:Plasma Substitutes