Adverse Events During Hematopoietic Stem Cell Infusion: Analysis of the Infusion Product.
BACKGROUND
Stem cell transplantation is a treatment option for patients with cancer. However, a risk of adverse events might be associated with the infusion itself. An understanding of the types and grades of adverse events occurring during infusion and the patient and infusion characteristics that might be associated with these events could allow for interventions to minimize these complications. The risk factors associated with transplant-related adverse events are not well understood.


METHODS
We retrospectively analyzed the adverse events occurring within 1 hour after infusion in 460 patients with cancer undergoing stem cell transplantation at the Northwestern University Robert H. Lurie Comprehensive Cancer Center from January 1, 2008 and May 1, 2011. Of the 460 patients, 382 received autologous transplants and 78 allogeneic transplants. The incidence, types, and National Cancer Institute Common Terminology Criteria grade of toxicity for adverse events were noted (primary objective). Univariate analyses were performed to study which patient and infusion characteristics might be associated with the occurrence of adverse events (secondary objectives).


RESULTS
Of the 460 patients, 261 (56.7%) experienced adverse events (66.7% during allogeneic infusion and 54.7% during autologous infusion). Most events were cardiopulmonary. Univariate analysis of the infusion and patient characteristics revealed that a second transplant (P = .005) was associated with more adverse events for autologous transplant patients. For allogeneic transplant patients, a higher infusion red blood cell volume (P = .01) was associated with more adverse events.


CONCLUSIONS
Adverse events are common during stem cell infusion and are generally cardiopulmonary.
Division of Hematology-Oncology, University of California, San Francisco, School of Medicine, San Francisco, CA. Electronic address: neelima.vidula@ucsf.edu.
Neelima
N
Vidula
John and Lillian Mathews Center for Cellular Therapy, Northwestern University Feinberg School of Medicine, Chicago, IL.
Marcelo
M
Villa
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Irene B
IB
Helenowski
John and Lillian Mathews Center for Cellular Therapy, Northwestern University Feinberg School of Medicine, Chicago, IL.
Mehboob
M
Merchant
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Borko D
BD
Jovanovic
Memorial Sloan-Kettering Cancer Center, New York, NY.
Richard
R
Meagher
John and Lillian Mathews Center for Cellular Therapy, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL; Robert H. Lurie Comprehensive Cancer Center, Chicago, IL.
Jayesh
J
Mehta
John and Lillian Mathews Center for Cellular Therapy, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL; Robert H. Lurie Comprehensive Cancer Center, Chicago, IL.
Seema
S
Singhal
John and Lillian Mathews Center for Cellular Therapy, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL; Robert H. Lurie Comprehensive Cancer Center, Chicago, IL.
Jane N
JN
Winter
John and Lillian Mathews Center for Cellular Therapy, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL; Robert H. Lurie Comprehensive Cancer Center, Chicago, IL.
Olga
O
Frankfurt
John and Lillian Mathews Center for Cellular Therapy, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL; Robert H. Lurie Comprehensive Cancer Center, Chicago, IL.
Jessica K
JK
Altman
Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL.
Stephanie F
SF
Williams
John and Lillian Mathews Center for Cellular Therapy, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL; Robert H. Lurie Comprehensive Cancer Center, Chicago, IL.
Leo I
LI
Gordon
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006412:Hematopoietic Stem Cells; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
Allogeneic transplantation; Autologous transplantation; Cardiopulmonary adverse events; Infusion red blood cell volume; Second transplant