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Cardiac arrest after autologous marrow infusion
A P Rapoport1, J M Rowe, C H Packman
1Hematology Unit, University of Rochester Medical Center, NY.
Bone Marrow Transplantation
|May 1, 1991
Summary
Acute non-cardiogenic pulmonary edema can occur immediately after autologous bone marrow transplantation. Risk factors may include active pulmonary tumors and prior transfusion reactions.
Area of Science:
- Hematology
- Oncology
- Critical Care Medicine
Background:
- Autologous bone marrow transplantation (ABMT) is a critical treatment for relapsed, refractory Hodgkin's disease.
- Understanding rare complications of ABMT is essential for patient safety and improved clinical protocols.
Observation:
- A 27-year-old woman developed acute non-cardiogenic pulmonary edema immediately post-transfusion of autologous bone marrow.
- This event occurred during ABMT for relapsed, refractory Hodgkin's disease.
Findings:
- The precise mechanisms of this rare reaction remain unclear.
- Potential causes include dimethylsulfoxide-induced anaphylaxis, leukoagglutination, complement activation, and transient left ventricular dysfunction.
- Identifying at-risk patients may involve considering active pulmonary tumors and a history of transfusion-related respiratory distress.
Implications:
- This case highlights a rare but serious complication of ABMT.
- Further research into the underlying mechanisms is warranted.
- Clinical vigilance for pulmonary complications in ABMT recipients is crucial, especially in patients with specific risk factors.