The correlation between the granulocyte content in infused stem cells and side effects of the infusion

Dear Sir, Haematopoietic progenitor blood stem cells (HPSC) collected by apheresis can be contaminated by granulocytes, which have been implicated in the adverse effects of infusion of HPSC in some reports1,2. We reviewed the records of infusion of autologous HPSC for the years 2004 and 2005 in patients with multiple myeloma, primary amyloidosis or lymphoma. The content of granulocytes infused was determined for each infusion and side effects reported during that infusion were recorded. Minor side effects were chills, rigors, wheezing, hypertension, dyspnoea, nausea, pain, flushing, anxiety, hives, haematuria and cramping diarrhoea. Major side effects were bradycardia, hypoxia and hypotension. Generalised estimating equations were used to assess the relationship between the development of side effects and the amount of granulocytes collected or infused. Three hundred and thirty-five patients (137 females and 198 males) were included in this study. Median age was 59 years (range 18 to 75). The following Table I summarizes the association between the development of minor and major SEs and the amount of granulocytes collected and infused. Table I Association between granulocytes and side effects. Tables II and III summarize the association between the diagnosis and any SE as well as with the major SEs. No deaths were documented due to infusion of HPSC in these patients. Table II Association between diagnosis code and any side effects in HPSCs infusion (p value = 0.43). Table III Association between diagnosis code and major side effects in HPSCs infusion (p-value = 0.30) We conclude that although there was a significant association between the amount of granulocytes and side effects of HPSC infusion, there were no deaths or side effects necessitating the withholding of the infusion and no correlations with the type of disease. These results do not support the need to establish protocols to reduce the amount of granulocytes when collecting HPSC.