Limiting the Daily Total Nucleated Cell Dose of Cryopreserved Peripheral Blood Stem Cell Products for Autologous Transplantation Improves Infusion-related Safety with No Adverse Impact on Hematopoietic Engraftment

Overview

Journal Biol Blood Marrow Transplant

Date 2011 Jun 28

PMID 21703976

Citations 3

Authors

Nandita Khera

Jack Jinneman

Barry E Storer

Shelly Heimfeld

Megan M OMeara

Thomas R Chauncey

Stephanie J Lee

Michael Linenberger

Affiliations

Soon will be listed here.

Abstract

Cryopreserved peripheral blood stem cell (PBSC) products can induce a number of infusion-related adverse reactions, including life-threatening cardiac, neurologic, and other end-organ complications. Preliminary analyses suggested limiting the daily total nucleated cell dose infused might decrease the incidence of these adverse effects. A policy change implemented in December 2007, limiting the total nucleated cell (TNC) dose to <1.63 × 10(9) TNC/kg/day, allowed us to assess the impact of this intervention on infusion-related safety, infusion schedules, engraftment, and costs in cohorts of patients undergoing autologous stem cell transplants (ASCTs) 2 years before (325 ASCTs in 288 patients) and 2 years after the policy change (519 ASCTs in 479 patients). The percentage of autologous transplant patients requiring multiple day infusions increased from 6% to 24%. Concurrently, the incidence of infusion-related grade 3-5 severe infusion-related adverse events (SAEs) decreased significantly, from 4% (13 of 325) prepolicy change to 0.6% (3 of 519) postpolicy change (P < .0004). Multiday infusions were not associated with increased time to neutrophil or platelet engraftment or the costs of transplantation. We conclude that limiting the daily TNC dose improved the safety of this procedure without compromising engraftment or increasing the costs of the procedure.

Citing Articles

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Truong T, Moorjani R, Dewey D, Guilcher G, Prokopishyn N, Lewis V Bone Marrow Transplant. 2016; 51(5):680-6.

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