Adverse reactions in patients transfused with cryopreserved marrow

Stroncek, DF; Fautsch, Susan K.; Lasky, Larry C.; Hurd, David D.; Ramsay, Norma K.C.; McCullough, Jeffrey

doi:10.1046/j.1537-2995.1991.31691306250.x

Cited by 174 publications

(130 citation statements)

References 12 publications

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“…Unlike receiving a simple blood transfusion, however, these infusions have the potential to cause a variety of adverse reactions (ARs). These range from common mild reactions including nausea, vomiting, flushing, fever, chills and cough [1][2][3] to rare life-threatening reactions affecting the cardiovascular, respiratory and neurological systems. [4][5][6][7] Infusion-related ARs have been attributed to both cellular and non-cellular elements within the cellular therapy product (CTP).…”

Section: Introductionmentioning

confidence: 99%

“…The earliest reports of DMSO toxicity during stem cell infusion describe characteristic side effects such as nausea, vomiting, abdominal pain, chills and fever. 1,2 Rare but serious side effects of cryopreserved products include severe respiratory depression, 7 neurotoxicity resulting in amnesia, loss of consciousness or seizure 5,6 and fatal cardiac arrhythmia. 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.…”

Section: Introductionmentioning

confidence: 99%

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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%

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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“…Since DMSO can act as a free radical scavenger and can cross the blood-brain barrier, it has also been used to treat brain edema (Broadwell et al, 1982;Ikeda et al, 1990). Although clinically beneficial in some situations, DMSO can have systemic side effects such as diarrhea, vomiting, bronchospasm, hypertension, and pulmonary edema (Davis et al, 1990;Hameroff et al, 1983;Smith et al, 1987;Stroncek et al, 1991). These effects appeared to be dose-dependent (Davis et al, 1990;Stroncek et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

“…Although clinically beneficial in some situations, DMSO can have systemic side effects such as diarrhea, vomiting, bronchospasm, hypertension, and pulmonary edema (Davis et al, 1990;Hameroff et al, 1983;Smith et al, 1987;Stroncek et al, 1991). These effects appeared to be dose-dependent (Davis et al, 1990;Stroncek et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Cytotoxic effects of dimethyl sulphoxide (DMSO) on cochlear organotypic cultures

2008

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The amphipathic molecule dimethyl sulphoxide (DMSO) is a solvent often used to dissolve compounds applied to the inner ear; however, little is known about its potential cytotoxic side effects. To address this question, we applied 0.1 to 6% DMSO for 24 h to cochlear organotypic cultures from postnatal day 3 rats and examined its cytotoxic effects. DMSO concentrations of 0.1% and 0.25% caused little or no damage. However, concentrations between 0.5 and 6% resulted in stereocilia damage, hair cell swelling and a dose-dependent loss of hair cells. Hair cell damage began in the basal turn of the cochlea and spread towards the apex with increasing concentration. Surprisingly, DMSO-induced damage was greater for inner hair cells than outer hair cell whereas nearby supporting cells were largely unaffected. Most hair cell death was associated with nuclear shrinkage and fragmentation, morphological features consistent with apoptosis. DMSO treatment induced TUNEL positive staining in many hair cells and activated both initiator caspase-9 and caspase-8 and executioner caspase-3; this suggests that apoptosis is initiated by both intrinsic mitochondrial and extrinsic membrane cell death signaling pathways.

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“…[3][4][5] However, in vivo experience with DMSO ever the etiologic agent is unclear. Basophils from a PBPC-allergic subject were challenged with each indihas shown no association with anaphylactic reactions, and in vitro studies suggest that DMSO may actually inhibit vidual component of the stem cell infusion and with recombinant human (rh)DNAse.…”

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confidence: 99%

Anaphylaxis during autologous peripheral blood progenitor cell infusion

Essayan¹,

SCHILDER

Kagey-Sobotka³

et al. 1997

Bone Marrow Transplant

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Summary:instances of systemic reactions resembling anaphylaxis have been reported in association with PBPC reinfusion; these reactions are frequently attributed to the presence of Anaphylaxis has been reported in subjects receiving peripheral blood precursor cell (PBPC) infusions; howdimethyl sulfoxide (DMSO) (in the cryopreserved cell preparations. [3][4][5] However, in vivo experience with DMSO ever the etiologic agent is unclear. Basophils from a PBPC-allergic subject were challenged with each indihas shown no association with anaphylactic reactions, and in vitro studies suggest that DMSO may actually inhibit vidual component of the stem cell infusion and with recombinant human (rh)DNAse. Histamine release data mediator release from both mast cells and basophils. 6,7 Thus, the pathogenesis of systemic reactions associated were compared with those using basophils from control subjects. Histamine release assays were repeated using with PBPC infusions remains unclear.We report herein the case of a subject with documented basophils from a control subject passively sensitized with serum IgE from the patient. Skin testing with bovanaphylaxis during two consecutive PBPC reinfusions. In vitro testing revealed IgE-mediated sensitivity to bovine ine DNAse was performed using standard techniques. Basophil histamine release occurred in the patient, but DNAse (commonly used to inhibit cellular aggregation), without crossreactivity to commercially available not in controls, with bovine DNAse. No release could be provoked by any of the other components of the infusrhDNAse, and no IgE-related sensitivity to DMSO. ate; no release could be detected with rhDNAse. Sensitivity to bovine DNAse could be transferred to basophils from a control subject with the serum IgE from the Case presentation patient. Marked epicutaneous skin test reactivity to bovine DNAse was evident in the patient, but not in control A 50-year-old female presented in November 1995 with primary peritoneal carcinoma and a CA-125 of 1037 IU/ml. subjects. We conclude that systemic reactions during peripheral blood precursor cell infusions may representIn December 1995, the patient began a regimen for mobilization of peripheral blood stem cells. Subsequent administrue IgE-mediated anaphylaxis to bovine DNAse in the infusate. Skin testing can detect such sensitivity, and the tration of high-dose carboplatin and paclitaxel in February 1996 was complicated by a hypersensitivity response to use of rhDNAse may obviate such reactions. Keywords: anaphylaxis; stem cell; IgE; DNAse; basopaclitaxel which was managed successfully utilizing newly published guidelines. 8 The patient's first stem cell reinphils fusion occurred 3 days later. Within 5 min of starting, the patient developed flushing with severe pruritus, gastrointestinal distress, shortness of breath, bronchospasm, tachyThe use of autologous peripheral blood progenitor cells cardia, profound hypotension, and altered sensorium. The (PBPCs) for bone marrow reconstitution in the treatment patient required intubatio...

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Adverse reactions in patients transfused with cryopreserved marrow

Cited by 174 publications

References 12 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

Cytotoxic effects of dimethyl sulphoxide (DMSO) on cochlear organotypic cultures

Anaphylaxis during autologous peripheral blood progenitor cell infusion

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