title: Febrile reaction associated with the infusion of haploidentical peripheral blood stem cells: incidence, clinical features, and risk factors.
abstract: BACKGROUND
  We reported febrile reaction after the infusion of haploidentical peripheral blood stem cells (PBSCs). The aim of this study was to better characterize this new clinical entity named by infusion-related febrile reaction (IRFR).
  
  
  METHODS
  A retrospective analysis of 490 patients received allogeneic stem cell transplantation (SCT) between October 2009 and December 2011 at our institution.
  
  
  RESULTS
  The distribution of transplant type was 173 patients in HLA-identical siblings, 30 in unrelated, and 287 in haploidentical. IRFR was defined as unexplained fever of more than 38°C within 24 hours after the infusion of allogeneic PBSCs. We did not observe any IRFRs in patients undergoing HLA-identical sibling and unrelated transfusions. After excluding patients with a known source of infection, we classified haploidentical patients into IRFR and non-IRFR groups. Eighty-eight patients (30.7%) of 287 cases after the infusion of haploidentical PBSCs were diagnosed as IRFRs, chills in 3.5% (10/88), diarrhea in 21.6% (19/88), an erythematous skin rash in 0.3% (1/88), hypoxemia in 1.0% (3/88), and no other accompanying symptoms in 62.5% (55/88). Significantly higher elevation of C-reactive protein and complement C3 was seen in the IRFR group compared with the non-IRFR group. Multivariate analysis showed higher CD34+ dose was a significant predictor for IRFR (p = 0.023; hazard ratio = 1.848; 95% confidence interval, 1.087-3.142).
  
  
  CONCLUSIONS
  As a clinical feature belonging to haploidentical SCT, IRFR was associated with the higher numbers of CD34+ from PBSCs.
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Huang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Kai-Yan
authors.initials: KY
authors.lastname: Liu
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Yu-Hong
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Zhang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Feng-Rong
authors.initials: FR
authors.lastname: Wang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Han
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Jing-Zhi
authors.initials: JZ
authors.lastname: Wang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Chen-Hua
authors.initials: CH
authors.lastname: Yan
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Zhang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Yu-Qian
authors.initials: YQ
authors.lastname: Sun
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China.
authors.forename: Lan-Ping
authors.initials: LP
authors.lastname: Xu
mesh_terms: D000017:ABO Blood-Group System / Q000235:genetics; D000293:Adolescent; D000328:Adult; D064591:Allografts; D018952:Antigens, CD34 / Q000097:blood; D001772:Blood Cell Count; D001787:Blood Group Incompatibility / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D003176:Complement C3 / Q000032:analysis; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology*; D006680:HLA Antigens / Q000235:genetics; D006239:Haplotypes; D006402:Hematologic Diseases / Q000628:therapy; D006648:Histocompatibility; D006801:Humans; D015994:Incidence; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D035781:Siblings; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System; D018952:Antigens, CD34; D003176:Complement C3; D006680:HLA Antigens; D002097:C-Reactive Protein