Department of Laboratory Medicine, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
BMC Cancer. 2022 Mar 14;22(1):268. doi: 10.1186/s12885-022-09298-6.
Cell-free and concentrated ascites reinfusion therapy (CART) is a strategy for improving various intractable symptoms due to refractory ascites, including hypoalbuminemia. CART has recently been applied in the treatment of cancer patients. This study was performed to assess the safety of CART in a single cancer institute.
We retrospectively reviewed 233 CART procedures that were performed for 132 cancer patients in our institute.
The median weight of ascites before and after concentration was 4,720 g and 490 g (median concentration rate, 10.0-fold), The median amounts of total protein and albumin were 64.0 g and 32.6 g (median recovery rates, 44.9% and 49.0%), respectively. Thirty-three adverse events (AEs) were observed in 22 (9.4%) of 233 procedures; 30 of these events occurred after reinfusion. The most common reinfusion-related AEs were fever (13 events) and chills (10 events). Univariate analyses revealed no significant relationships between the frequency of AEs and age, sex, appearance of ascites, weight of harvested and concentrated ascites, the ascites processing rate (filtration and concentration), weight of saline used for membrane cleaning, amount of calculated total protein for infusion, or prophylaxis against AEs; the reinfusion rate of ≥ 125 mL/h or ≥ 10.9 g/h of total protein affected the frequency of AEs, regardless of the prophylactic use of steroids.
The observed AEs were mainly mild reactions after reinfusion, which were related to a reinfusion rate of volume ≥ 125 mL/h, a simple indicator in practice, or total protein ≥ 10.9 g/h. Although our study was retrospective in nature and undertaken in a single institute, this information may be helpful for the management of cancer patients with refractory malignant ascites using CART.
无细胞浓缩腹水再输注疗法（CART）是一种策略，可改善由于难治性腹水引起的各种难治性症状，包括低白蛋白血症。CART 最近已应用于癌症患者的治疗。本研究旨在评估单一癌症中心 CART 的安全性。
我们回顾性分析了我院 132 例癌症患者 233 例 CART 操作。
浓缩前后腹水的中位重量分别为 4720g 和 490g（中位浓缩率为 10.0 倍），总蛋白和白蛋白的中位量分别为 64.0g 和 32.6g（中位回收率分别为 44.9%和 49.0%）。233 例操作中观察到 33 例不良事件（AE），22 例（9.4%）操作中发生 30 例。最常见的再输注相关 AE 是发热（13 例）和寒战（10 例）。单因素分析显示，AE 频率与年龄、性别、腹水外观、收获和浓缩腹水的重量、腹水处理率（过滤和浓缩）、用于膜清洗的生理盐水重量、输注计算的总蛋白量、或预防 AE 之间无显著关系；再输注率≥125ml/h 或≥10.9g/h 的总蛋白影响 AE 频率，与类固醇的预防性使用无关。
观察到的 AE 主要是再输注后的轻度反应，与再输注率≥125ml/h 或总蛋白≥10.9g/h 相关，这是实践中的简单指标。尽管本研究为回顾性且在单一中心进行，但这些信息可能有助于管理使用 CART 治疗难治性恶性腹水的癌症患者。
