Toxicities of mobilized stem cell infusion

Area of Science:

• Hematology
• Cell Therapy
• Transplantation Medicine

Background:

• Infusion of hematopoietic stem cells (bone marrow or cytokine-mobilized) carries risks.
• Potential causes of toxicity include infusion volume, dimethylsulfoxide (DMSO), and microbial contamination.
• Adverse events necessitate careful monitoring and management by healthcare teams.

Purpose of the Study:

• To outline the spectrum of toxicities associated with stem cell infusions.
• To detail the etiology of both severe and non-life-threatening adverse events.
• To define the roles of healthcare professionals in managing infusion-related toxicities.

Main Methods:

• Review of known toxicities and their causes in stem cell infusion protocols.
• Categorization of adverse events into severe (life-threatening) and non-life-threatening.
• Description of monitoring and management strategies for identified toxicities.

Main Results:

• Severe toxicities include hypotension, hypertension, cardiac arrhythmias, and respiratory failure.
• Common non-life-threatening toxicities are fever, chills, nausea, and vomiting.
• Fever can stem from infection or cytokines released by leukocytes; other events may relate to processing reagents.

Conclusions:

• Stem cell infusions require vigilant monitoring for a range of potential toxicities.
• Prompt medical intervention is crucial for managing severe adverse events.
• Effective management involves understanding the diverse etiologies and defining clear roles for nurses, technicians, and physicians.