title: Few and nonsevere adverse infusion events using an automated method for diluting and washing before unrelated single cord blood transplantation.
abstract: Graft dilution and DMSO washing before cord blood (CB) administration using an automated system may offer low incidence of adverse infusion events (AIE), ensuring reproducible cell yields. Hence, we analyzed the incidences and significance of immediate AIE, cellular yield, and engraftment after single CB infusion. One hundred and fifty-seven patients (median age, 20 years; range, 1 to 60) received a single CB unit for treatment of hematologic and nonhematologic malignancies with myeloablative conditioning after graft dilution and washing. The median total nucleated cell (TNC) doses was 3.4 × 10(7)/kg (range, 2 to 26) and the median post-thaw recovery was 84% (range, 45 to 178). The cumulative incidence of neutrophil engraftment at 50 days was 84% (95% confidence interval [CI], 83 to 93). A total of 118 immediate AIE were observed in fifty-two (33%) patients. All reported AIE were transient, graded from 1 to 2 by Common Terminology Adverse Events version 4. The most frequent toxicity was cardiovascular but without any life-threatening reaction. Infused TNC, recipient's weight, and rate of infusion per kilogram were risk factors associated with cardiovascular AIE in multivariate analysis (odds ratio [OR], 1.2 (95% CI, 1.1 to 1.4); P < .001; OR, .94 (95% CI, .9 to .97); P < .001; and OR, 1.5 (95% CI, 1.2 to 1.8); P < .001; respectively). In summary, use of an automated method for graft washing before CB administration showed low incidence of AIE without compromising cell yields and engraftment. Infused TNC dose, recipient's weight, and rate of infusion per kilogram were risk factors associated with infusion reactions.
authors.affiliation: Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain. Electronic address: nercastillo@vhebron.net.
authors.forename: Nerea
authors.initials: N
authors.lastname: Castillo
authors.affiliation: Hospital Universitari de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: García-Cadenas
authors.affiliation: Adult Hematology Department, Institut Català d'Oncologia-Badalona, Barcelona, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: García
authors.affiliation: Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Barba
authors.affiliation: Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Diaz-Heredia
authors.affiliation: Hospital Universitari de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Martino
authors.affiliation: Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Azqueta
authors.affiliation: Adult Hematology Department, Institut Català d'Oncologia-Badalona, Barcelona, Spain.
authors.forename: Christelle
authors.initials: C
authors.lastname: Ferrà
authors.affiliation: Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Canals
authors.affiliation: Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Izaskun
authors.initials: I
authors.lastname: Elorza
authors.affiliation: Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Olivé
authors.affiliation: Hospital Universitari de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Badell
authors.affiliation: Hospital Universitari de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.affiliation: Adult Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Duarte
authors.affiliation: Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Valcárcel
authors.affiliation: Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Querol
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006085:Graft Survival; D006412:Hematopoietic Stem Cells; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors; D019172:Transplantation Conditioning
keywords: Graft washing; Safety; Transplantation; Umbilical cord blood