Adverse reactions of collection and return infusions of autologous peripheral blood stem cells in children with malignant solid tumors

Abstract

Objective To study the adverse reactions of collection and return infusions of autologous periphe-ral blood stem cells (APBSC) in children with malignant solid tumors. Methods Thirty-eight cases' clinical data diagnosed as advanced malignant solid tumors in children by pathological examination were collected from September 2005 to November 2011 in Beijing Tongren Hospital (27 male patients and 11 female patients). All cases were given high-dose chemotherapy and APBSC transplantation(APBSCT). According to world health organization(WHO) stan-dard of the adverse reactions of chemotherapy and radiotherapy and the Bearman standard of the adverse reactions of APBSCT, cli-nical data of these cases were analyzed.The adverse reactions of collection and return infusions of APBSC were summarized. Results (1)Mononuclear cell (MNC) count of 38 cases was (5.6±2.2)×108/kg, and CD34+ cell counts was (3.8±2.6)×106/kg.MNC count or CD34+ cell count of 31 cases was conformed to the standards.The coincidence rate was 81.6% (31/38 cases). (2)On (12.3±3.1) days, 38 cases obtained bone marrow reconstruction after return infusions of APBSC.The correlation coefficient of CD34+ cells count and bone marrow reconstruction was rs=-0.634, and that was negatively correlated(P=0.001). (3)Adverse reactions during APBSC collection and return infusions; the most adverse reactions during APBSC collection were arrhythmia, hypotension, gastrointestinal reaction and thrombocytopenia, et al.The main adverse reactions during APBSC return infusions were hemoglobinuria, hypertension and gastrointestinal reaction.The occurring rate of hemoglobinuria was 100%, but urine color gradually returned to normal after they were given the hydration and alkalization.(4) Adverse reactions during bone marrow suppression after return infusions: 38 patients with high-dose chemotherapy on + 3 to + 14 d were presented with toxic side effects those including 19 cases in grade Ⅰ, 11 cases in grade Ⅱ, 5 cases in grade Ⅲ, and 3 cases in grade Ⅳ(but 1 case died in the 3 cases). On + 15 to + 22 d, 37 patients with high-dose chemotherapy, 33 cases showed no adverse reactions, and 2 cases in grade Ⅰ, 2 cases in grade Ⅱ.On + 23 to + 40 d, the adverse reactions of 37 cases with high-dose chemotherapy were corrected. Conclusion The adverse reactions of APBSC were transient and no organ damage was observed, which was safe and reliable. Key words: Solid tumor; Autologous peripheral blood stem cell transplantation; Chemotherapy; Adverse reactions; Child