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Safety of hematopoietic cell infusion in children with malignant and non‐malignant diseases
Author(s) -
Heneghan Chelsea,
Smilow Elana,
Tanhehco Yvette,
Jin Zhezhen,
Cofnas Paige,
Schwartz Sharon,
Patel Nita,
Carberry Deborah,
Silverman Justin,
Huynh Paul,
Hagan Brittany,
Tobin Kim,
Bhatia Monica,
George Diane,
Garvin James,
Satwani Prakash
Publication year - 2017
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13038
Subject(s) - medicine , incidence (geometry) , adverse effect , surgery , optics , physics
HPC infusions have been associated with a variety of adverse events related to either patient or HPC product‐related factors. Studies documenting infusion‐related AE s in children are limited. We reviewed HPC infusion records in 354 children. Infusion‐related adverse events were classified as follows: grade 0—absent, grade I—mild, grade II —moderate, grade III —severe, grade IV —life‐threatening, and grade V—death. The percentage of patients with grade 0, I, and II ‐ IV AE s was as follows: 0 = 67%, I = 23.4%, and II ‐V = 9.6% (one patient had fatal anaphylactic reaction to dimethyl sulfoxide). The incidence of grade II ‐ IV hypertension was 7.1%. There was a higher incidence of AE s with infusion of allogeneic bone marrow versus allogeneic PBSCs (47.4% vs 25.3%, P = .001). Cryopreserved products had a lower incidence of infusion‐associated AE s compared with fresh HPC products (24% vs 39.4%, P = .003). Allogeneic HPC infusion volume (>100 mL) was a significant risk factor for infusion‐associated AE s ( P < .001). Patients >10 years who received autologous HPC infusions had higher risk of AE s when compared to patients <10 years ( P = .01). Our study demonstrated that despite a high incidence of infusion‐associated hypertension, HPC infusion is relatively safe in children. Investigating strategies to optimize management of hypertension in the setting of HPC infusion is warranted.