Febrile reaction associated with the infusion of haploidentical peripheral blood stem cells: incidence, clinical features, and risk factors

Transfusion - Tập 55 Số 8 - Trang 2023-2031 - 2015
Yao Chen1, Xiao‐Jun Huang1, Yu Wang1, Kai‐Yan Liu1, Huan Chen1, Yu‐Hong Chen1, Xiao‐Hui Zhang1, Feng‐Rong Wang1, Wei Han1, Li Wang1, Chen‐Hua Yan1, Yuanyuan Zhang1, Yu‐Qian Sun1, Lan‐Ping Xu1
1Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, People’s Republic of China

Tóm tắt

BACKGROUNDWe reported febrile reaction after the infusion of haploidentical peripheral blood stem cells (PBSCs). The aim of this study was to better characterize this new clinical entity named by infusion‐related febrile reaction (IRFR).STUDY DESIGN AND METHODSA retrospective analysis of 490 patients received allogeneic stem cell transplantation (SCT) between October 2009 and December 2011 at our institution.RESULTSThe distribution of transplant type was 173 patients in HLA‐identical siblings, 30 in unrelated, and 287 in haploidentical. IRFR was defined as unexplained fever of more than 38°C within 24 hours after the infusion of allogeneic PBSCs. We did not observe any IRFRs in patients undergoing HLA‐identical sibling and unrelated transfusions. After excluding patients with a known source of infection, we classified haploidentical patients into IRFR and non‐IRFR groups. Eighty‐eight patients (30.7%) of 287 cases after the infusion of haploidentical PBSCs were diagnosed as IRFRs, chills in 3.5% (10/88), diarrhea in 21.6% (19/88), an erythematous skin rash in 0.3% (1/88), hypoxemia in 1.0% (3/88), and no other accompanying symptoms in 62.5% (55/88). Significantly higher elevation of C‐reactive protein and complement C3 was seen in the IRFR group compared with the non‐IRFR group. Multivariate analysis showed higher CD34+ dose was a significant predictor for IRFR (p=0.023; hazard ratio = 1.848; 95% confidence interval, 1.087‐3.142).CONCLUSIONAs a clinical feature belonging to haploidentical SCT, IRFR was associated with the higher numbers of CD34+ from PBSCs.

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Transfusion

Tập 55 Số 8

2023-2031

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