Infusion technique of hematopoietic progenitor cells and related adverse events (CME).
BACKGROUND
The use of hematopoietic progenitor cell (HPC) transplant has risen over the past two decades. A variety of adverse events (AEs) of varying severity have been noted during HPC infusions. These AEs have been associated with several factors such as the amount of dimethyl sulfoxide and white blood cells in the HPC product. We performed a single-institution retrospective analysis to determine the effect of two different HPC infusion techniques, manual push with syringes versus infusion from bags with the aid of gravity, on the occurrence of infusion-related AEs.


METHODS
Infusions between December 2008 and November 2010 involving peripheral blood HPCs were reviewed. Pertinent clinical and HPC product-related information was recorded. Data were analyzed to determine the incidence of infusion-related AEs and its association with patient and product-related variables.


RESULTS
We found 461 AEs in 645 patients during the study period. A total of 325 (50%) experienced at least one AE. Flushing was the most common type of AE followed by nausea and hypertension. The use of syringe infusion was more commonly associated with AEs (odds ratio, 1.82 [95% confidence interval, 1.32-2.50]; p=0.002). Other independent risk factors were cryopreserved products and the amount of polymorphonuclear leukocytes in the product.


CONCLUSIONS
To our knowledge, this is the first study examining the effect of two different infusion techniques on infusion-related AEs. Our findings suggest that the use of bags for infusion protected the patients from AEs.
Division of Hematology/Oncology, University of Connecticut Health Center, Farmington, Connecticut.
Sudhanshu B
SB
Mulay
Carl W
CW
Greiner
Amy
A
Mohr
Sandra C
SC
Bryant
Ravi K
RK
Lingineni
Doug
D
Padley
William J
WJ
Hogan
Dennis A
DA
Gastineau
Eapen K
EK
Jacob
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D001793:Blood Preservation / Q000295:instrumentation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D003451:Cryoprotective Agents / Q000009:adverse effects; D004121:Dimethyl Sulfoxide / Q000009:adverse effects; D004155:Diphenhydramine / Q000627:therapeutic use; D005483:Flushing / Q000209:etiology*; D005665:Furosemide / Q000627:therapeutic use; D019337:Hematologic Neoplasms / Q000601:surgery; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D006973:Hypertension / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous / Q000009:adverse effects* / Q000379:methods; D007552:Isotonic Solutions / Q000009:adverse effects; D008875:Middle Aged; D009325:Nausea / Q000209:etiology*; D009504:Neutrophils / Q000276:immunology / Q000637:transplantation; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D011292:Premedication; D012189:Retrospective Studies; D012307:Risk Factors; D013594:Syringes; D055815:Young Adult
D003451:Cryoprotective Agents; D007552:Isotonic Solutions; D000082:Acetaminophen; C017577:normosol R; D005665:Furosemide; D004155:Diphenhydramine; D006854:Hydrocortisone; D004121:Dimethyl Sulfoxide