title: Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation.
abstract: Adverse reactions (ARs) during the infusion of cellular therapy products (CTPs) are common in patients undergoing hematopoietic stem cell transplantation (HSCT). We retrospectively studied pediatric patients undergoing autologous and allogeneic HSCT to determine the incidence and grade of ARs during stem cell infusion and their predictors. We analyzed data from 213 patients (120 allogeneic and 93 autologous) who received at least 1 CTP, totaling 361 infusion episodes. Serious ARs, defined as grade 2 and 3, occurred in 25 and 11% of infusions, respectively. No grade 4 or 5 ARs were noted. Independent risk factors for developing a serious AR included stem cell source (PBSC vs marrow (odds ratio (OR) 1.8, 95% confidence interval (CI): 0.4-9); cord vs marrow (OR 7.3, 95% CI: 1.3-40), overall P=0.0001) but manipulated CTPs were protective (OR 0.4, 95% CI: 0.2-0.7, P=0.004). Unlike previous adult studies, WBC and granulocyte content were not found to be risk factors in this pediatric population. These data suggest that children tolerate higher WBC content during infusion of CTPs and support the use of manipulated CTP, as indicated, to reduce the risk of adverse infusion reactions.
authors.affiliation: Section of Pediatric Oncology, Blood and Marrow Transplant, Department of Oncology and Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Canada.
authors.forename: T H
authors.initials: TH
authors.lastname: Truong
authors.affiliation: Section of Pediatric Oncology, Blood and Marrow Transplant, Department of Oncology and Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Moorjani
authors.affiliation: Department of Pediatrics and Community Health Sciences, University of Calgary, Alberta Children's Hospital Research Institute for Child and Maternal Health, Calgary, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Dewey
authors.affiliation: Section of Pediatric Oncology, Blood and Marrow Transplant, Department of Oncology and Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Canada.
authors.forename: G M T
authors.initials: GM
authors.lastname: Guilcher
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada.
authors.forename: N L
authors.initials: NL
authors.lastname: Prokopishyn
authors.affiliation: Section of Pediatric Oncology, Blood and Marrow Transplant, Department of Oncology and Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Canada.
authors.forename: V A
authors.initials: VA
authors.lastname: Lewis
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006098:Granulocytes; D006801:Humans; D007962:Leukocytes; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D013234:Stem Cells / Q000166:cytology; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous