Post-thaw removal of DMSO does not completely abrogate infusional toxicity or the need for pre-infusion histamine blockade

Rowley, SD; Feng, Ziding; Yadock, David; Holmberg, Leona; MacLeod, B.; Heimfeld, Shelly

doi:10.1080/0032472031000141303

Cited by 44 publications

(47 citation statements)

References 14 publications

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“…4 Efforts aimed at reducing the DMSO content of infused grafts either by washing or other means have resulted in a reduction of ARs among some studies, 8,9 but not others. 10 No relationship between DMSO and ARs in cord blood transplants has been observed. 11 High WBC concentration, especially due to granulocytes or PMNs, has been associated with increased frequency and severity of ARs.…”

Section: Introductionmentioning

confidence: 99%

Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation

Truong

Moorjani

Dewey

et al. 2016

Bone Marrow Transplant

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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.

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Section: Introductionmentioning

confidence: 99%

Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation

Truong

Moorjani

Dewey

et al. 2016

Bone Marrow Transplant

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“…1 The occurrence of adverse events during the infusion of previously cryopreserved autologous PBSC is well known. [2][3][4] These events have traditionally been attributed to the presence of DMSO in the thawed cell suspension. The infusion of DMSO gives rise to dosedependent gastrointestinal, cardiovascular and neurological toxicity.…”

Section: Introductionmentioning

confidence: 99%

The occurrence of adverse events during the infusion of autologous peripheral blood stem cells is related to the number of granulocytes in the leukapheresis product

Córdoba

Arrieta

Kerguelen

et al. 2007

Bone Marrow Transplant

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Toxicity related to autologous PBSC infusion is well known and traditionally attributed to the presence of DMSO as cryoprotectant. But despite DMSO depletion, adverse events continue appearing. We have conducted a retrospective study to determine the incidence of adverse events related to the PBSC infusion in a large series of 144 patients. Adverse effects were observed in 67.36% of patients, although most of them were of grade 1 or 2. The adverse events most frequently reported were allergic reactions, followed by general, gastrointestinal and respiratory symptoms. In the univariate analysis, age (P ¼ 0.01), the volume infused (P ¼ 0.005), the amount of DMSO (P ¼ 0.008), the total nucleated cells (P ¼ 0.002), the total number of granulocytes (P ¼ 0.000001) and clumping (P ¼ 0.000001) were associated with the occurrence of adverse events. In the multivariate analysis, two protective factors, age (P ¼ 0.05) and sex (P ¼ 0.004), and two risk factors, the number of granulocytes, with a relative risk of 1.18 (95% confidence interval, 1.06-1.31) (P ¼ 0.002), and clumping, with an relative risk of 1.94 (95% confidence interval, 1.15-3.29) (P ¼ 0.013), were identified. The best cutoff point for the prediction of the occurrence of adverse events, with a sensitivity of 47% and specificity of 89%, was 6.065 Â 10 9 granulocytes.

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“…[1][2][3][4][5][6][7] Multiple hypotheses have been generated to account for such toxicity, including acute volume expansion or a direct effect of the cryopreservative dimethyl sulfoxide (DMSO), 3,4,6 but supporting data remain controversial. 3,[7][8][9][10][11][12][13] The volume of infused red blood cells (RBCs) contained within PBSC grafts has been positively correlated with a greater number of side effects. 1 RBC lysis, which occurs during the freeze-thaw process, leads to the release of free hemoglobin (Hb), which could hypothetically result in impaired vasomotor tone because of nitric oxide (NO) consumption.…”

Section: Introductionmentioning

confidence: 99%

Infusion of hemolyzed red blood cells within peripheral blood stem cell grafts in patients with and without sickle cell disease

Fitzhugh

Unno

Hathaway

et al. 2012

Blood

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Post-thaw removal of DMSO does not completely abrogate infusional toxicity or the need for pre-infusion histamine blockade

Cited by 44 publications

References 14 publications

Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation

Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation

The occurrence of adverse events during the infusion of autologous peripheral blood stem cells is related to the number of granulocytes in the leukapheresis product

Infusion of hemolyzed red blood cells within peripheral blood stem cell grafts in patients with and without sickle cell disease

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