Nº. |
Synthesis |
E1
(18)
|
AR: Of the 60 patients, 13 (22%) had AR. Rash or flushing, nausea, bradycardia, chills, hypotension, volume overload. |
Conclusion: There is no clinical benefit in dividing the infusion over multiple days, as the toxicity was similar in the 03 patient groups. However, the authors point out that the infusion division avoids the administration of a high dose of DMSO per day. |
E2
(19)
|
AR: Severe fatal bradyarrhythmia. |
Conclusion: Age and multiple organ dysfunction contributed to the outcome. The DMSO and the HCS volume contributed to the AR. The authors point out that the removal of DMSO and cell debris by washing procedures may reduce the risk of AR related to the infusion. |
E3
(20)
|
AR: Of the 32 infusions, AR was observed in 15 (47%). Bradycardia, hemoglobinuria, headache, abdominal pain. |
Conclusion: The AR were not severe and most were observed in the HSCBM infusion. The administration of pre-medications and the limitation of the amount of infused DMSO decrease the intercurrences during the infusion of the HSC. |
E4
(21)
|
AR: Of the 490 infusions, AR was observed in 66 (13%). Classified by degree of severity: Degree 1: throat irritation, excitement, visual impairment, nausea, pruritus, vertigo, chest pain. Degree 2: emesis, vasovagal episode, flushing, tremor, confusion, abdominal pain, headache. Degree 3: loss of sight. Degree 4: cardiac arrest, loss of consciousness, seizure. |
Conclusion: The occurrence of AR is directly related to the amount of granulocytes and not only to the toxicity of the DMSO. |
E5
(22)
|
AR: Of the 34 patients, 27 (80%) had AR and were classified as: Cardiovascular toxicity: diastolic hypertension, systolic hypertension, bradycardia and extra-systole. Non-cardiovascular toxicity: nausea, emesis, headache, chest discomfort and saturation drop. |
Conclusion: Cardiovascular toxicity with hypertension and bradycardia are more frequent AR in the cryopreserved HSCUPCB infusion. The results suggest that the infusion without manipulation after thawing is safe and well tolerated. |
E6
(23)
|
AR: Study with 158 patients that does not indicate the proportion of AR. In addition to nausea and emesis, focus of the study, other ARs were observed: hypoxia, cough, dyspnea, abdominal pain, tachycardia, agitation, chills, chest pain, fever, hypertension, hypotension, throat irritation, hiccups and arrhythmia. |
Conclusion: Cryopreserved HSC infusion can trigger nausea and emesis, probably because of the taste and flavor of the DMSO metabolites. The use of strawberry-flavored lollipops during the infusion of cryopreserved HSCPB in the autologous transplantation may be promising in reducing nausea and emesis, with ease of use and low cost. |
E7
(24)
|
AR: Of the 262 infusions, AR was observed in 149 (57%). Classified by degree of severity. Degree 1: hypertension, nausea, throat irritation, bad taste in the mouth, hot flashes, chills, abdominal pain, chest discomfort, dyspnea, palpitation and cough; Degree 2: emesis, hypertension with emesis, hypertension with nausea, hypotension with emesis, nausea with vertigo, hypertension with headache and nausea with palpitations. No degree 3 and 4 AR were observed. |
Conclusion: The amount of DMSO infused, the product composition (number of granulocytes) as well as the patient’s characteristics (gender, diagnosis) are important factors for infusion-related toxicity. |
E8
(25)
|
AR: Of the 53 patients, 19 (36%) had AR. Classified by organic systems: Cardiovascular: bradycardia, tachycardia, hypotension and hypertension. Gastrointestinal: nausea, emesis and abdominal pain. Other ARs: chest pain, headache and vasovagal episode. |
Conclusion: DMSO depletion by manual washing technique reduces AR related to the cryopreserved HSC infusion. |
E9
(26)
|
AR: Of the 423 infusions, AR was observed in 105 (25%). Classified by organic systems. Gastrointestinal: nausea, emesis, diarrhea and abdominal pain. Respiratory: cough, throat irritation and dyspnea. Cardiovascular: hypertension, hypotension and chest pain. Dermatological: pruritus and erythema. Other ARs: hemoglobinuria, fever, arm pain and vasovagal episode. Neurological: headache, convulsion and loss of consciousness. |
Conclusion: The incidence and severity of the AR during the infusion of the cryopreserved HSCPB are related to the amount of granulocytes present in the product. |
E10
(27)
|
AR: Study with 52 patients (26 in each group) that did not indicate the proportion of AR. Group that received HSC with DMSO depletion: abdominal pain, nausea and emesis. Group that received HSC without DMSO depletion: arrhythmia, hypotension, hypertension, nausea, emesis, abdominal pain and hypoxia. |
Conclusion: The DMSO depletion by the automated washing technique significantly reduces AR during the cryopreserved CTH infusion. |
E11
(12)
|
AR: Study with 479 patients that does not indicate the proportion of AR. Seizure and chest pain. |
Conclusion: Limiting the daily dose of total nucleated cells and/or granulocytes (dividing the infusion over multiple days) reduces severe AR. |
E12
(28)
|
AR: Of the 54 patients, 10 (19%) had AR. Fever and hives. |
Conclusion: The infusion of HSC containing DMSO reversibly activated the coagulation. However, this finding is not associated with acute AR and does not influence the graft attachment. |
E13
(29)
|
AR: Of the 645 patients, 325 (50%) had AR. Flushing, nausea, hypertension, diarrhea, hypotension, hypoxia, hemoglobinuria, anxiety, pain, bradycardia, dyspnea, chills, and hives. |
Conclusion: The occurrence of AR related to the infusion of HSC is common. The infusion by the manual technique with syringe is associated to the higher incidence of AR when compared to the gravitational infusion. And patients who received fresh HSC developed less flushing than those receiving cryopreserved HSC. |
E14
(30)
|
AR: Of the 1651 patients, 862 (52%) had AR. Nausea, emesis, hypertension and hypotension. The study also reported AR less recurrent classified as: respiratory, cardiac, neurological, gastrointestinal and allergic, but did not specify which. |
Conclusion: The implementation of methods that reduce the concentration of DMSO in the cryopreservation of HSC and emphasize the attention to the dose of this preservative to reduce toxicity and morbidity in the procedure of HSCT. |
E15
(5)
|
AR: Of the 460 patients, 261 (57%) had AR. Classified by organic systems: Cardiovascular: bradycardia, chest pain, elevation of troponin, hypertension, hypotension, tachycardia and cardiac arrest. Respiratory: dyspnea and hypoxia. Constitutional or non-specific: headache, sweating, back pain, fever, hypothermia, throat irritation, heat waves and flushing. Neurological and/or Psychiatric: cerebrovascular accident, changes in vision, anxiety, unconsciousness, peripheral neuropathy and vertigo. Gastrointestinal: abdominal pain, emesis and nausea. Genitourinary: hemoglobinuria. |
Conclusion: AR are common during the infusion of HSC, and they are generally not life threatening and mostly affect the cardiovascular and respiratory systems. It has been observed that AR are more common in recipients of the second autologous HSCT and in those receiving a higher volume of red blood cells in allogeneic HSCT. |
E16
(31)
|
AR: Of the 213 patients, the AR were classified by moment of occurrence and degree of severity. Degree 1: 55% during infusion and 62% within 24 hours of the infusion; Degree 2: 10% before and 18% after; Degree 3: 4% before and 7% after. The AR were: nausea, emesis, cough, flushing, tachycardia, hypertension, fever, headache, chest pain, pain, chills, bradycardia, hypotension, allergic reaction, visual disturbance, diarrhea, difficulty breathing, loss of consciousness and hypoxia. |
Conclusion: Infusion of HSC in pediatrics is a safe procedure. The results suggest that, unlike the adult literature, there is no association between the DMSO, granulocyte concentration and the development of a severe AR. The study supports the use of manipulated products to reduce the risk of AR to the infusion. |
E17
(32)
|
AR: Of the 1269 infusions, AR was observed in 480 (38%). Flushing, nausea, emesis, hypoxia, chest pain, difficulty breathing, bradycardia, hypertension, hypotension and tachycardia. |
Conclusion: The AR, although not severe, occurred in more than a third of the patients. Many of the AR can be attributed to the DMSO and this is reflected in the infusion volume. They suggest the implementation of DMSO reduction protocols prior to the infusion. In addition to the DMSO, other variables such as granulocyte count, sex and diagnosis are risk factors for the occurrence of AR. |
E18
(33)
|
AR: In the infusion of fresh HSC: no AR. Cryopreserved HSC infusion: headache, hypertension, bradycardia, hypothermia and convulsion. |
Conclusion: The neurotoxicity caused by the DMSO, although rare, is a serious complication. Attention should be paid to patients receiving cryopreserved HSC. |