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Cardiac arrhythmia after infusion of cryopreserved stem cells
1University of Southern California, Department of Medicine, Los Angeles.
Insights
Cryopreserved stem cell infusions can cause serious cardiac side effects like arrhythmia and heart block. Continuous cardiac monitoring is recommended during and after infusions to manage these potential cardiovascular risks.
Area of Science:
- Hematology
- Cardiology
- Oncology
Background:
- Autologous bone marrow and peripheral blood stem cell transplantation is a critical treatment modality.
- Cryopreservation of stem cells is a standard procedure.
- Cardiovascular complications following stem cell infusion require further investigation.
Purpose of the Study:
- To investigate the cardiovascular side effects of unpurged cryopreserved autologous stem cell infusions.
- To identify the types and incidence of cardiac events during and after stem cell infusion.
- To establish recommendations for patient monitoring.
Main Methods:
- A retrospective study was conducted on 17 patients undergoing autologous stem cell transplantation.
- Cardiovascular events were monitored during and after the infusion of cryopreserved stem cells.
- Data on cardiac rhythm, heart rate, and blood pressure were analyzed.
Main Results:
- 82% of patients experienced cardiac arrhythmia, including sinus bradycardia (65%) and heart block (24%).
- Hypertension was observed in 41% of patients, typically within 2 hours of infusion.
- No mortality or symptomatic events were reported, despite electrophysiologically severe arrhythmias.
Conclusions:
- Unpurged cryopreserved autologous stem cell infusions are associated with significant cardiovascular side effects.
- Continuous cardiac monitoring is advisable during and after stem cell infusion due to the potential for severe arrhythmias.
- Proactive cardiac monitoring can aid in the early detection and management of infusion-related cardiovascular events.
Abstract:
A retrospective study of the cardiovascular side-effects of 17 patients during and after receiving unpurged cryopreserved autologous bone marrow and/or peripheral blood stem cells was performed. Fourteen (82%) patients developed cardiac arrhythmia, of which 11 (65%) developed sinus bradycardia, four (24%) second degree heart block and one patient had complete heart block. The onset of sinus bradycardia occurred at 15-513 (median 56) min and the onset of heart block ranged from 30 to 680 (median 234) min after starting the stem cell infusion. Hypertension was noted in seven patients (41%) and usually occurred within 2 hours of infusion. There was no mortality or symptoms associated with these findings. Since some of these arrhythmias could be quite severe as assessed electrophysiologically, continuous cardiac monitoring should be considered during and after the infusion of cryopreserved stem cells.