López-Jiménez J, Cerveró C, Muñoz A, Hernández-Madrid A, Fernández Pineda J, García Laraña J, Moro C, Maldonado M, Pérez Oteyza J, Otheo E
Department of Hematology, Hospital Ramón y Cajal, Madrid, Spain.
Bone Marrow Transplant. 1994 Jun;13(6):789-93.
To evaluate cardiovascular toxicities associated with the infusion of cryopreserved grafts, we prospectively monitored the infusions of 29 autologous bone marrow transplant (BMT) recipients. Fifteen allogeneic BMT recipients served as a control group. Cardiac rhythm was recorded continuously with the Holter technique from at least 2 h before the start of graft infusion until 24 h after completion. Blood pressure was closely monitored during the same period. Graft infusions were performed through a standard transfusion filter with breaks between aliquots. When the infusion had commenced, diuretics were given frequently (40 and 40% of allogeneic BMT and autologous BMT recipients, respectively) to avoid fluid overload. Non-cardiovascular clinical toxicities were observed more frequently in autologous BMT patients (41% vs 6%, p = 0.02) and no significant differences were seen between autograft and allograft recipients in any of the measured cardiovascular parameters. The heart rate decreased slightly in both groups but no patient in either group had a heart rate of < 60 b.p.m. or heart block. No significant changes in blood pressure were detected in either group. Ventricular ectopic beats/atrial ectopic beats ratio increased in the autologous BMT group after graft infusion (0.7 vs 0, p = 0.1). Time to engraftment did not differ significantly from other published series. Our results suggest that increasing infusion time of cryopreserved material and using a standard filter may reduce toxicities associated with the infusion of cryopreserved grafts. Early administration of diuretics may contribute to better control of blood pressure.
为评估与输注冷冻保存移植物相关的心血管毒性，我们前瞻性地监测了29例自体骨髓移植（BMT）受者的输注情况。15例同种异体BMT受者作为对照组。采用动态心电图技术，从移植物输注开始前至少2小时直至输注完成后24小时连续记录心律。同期密切监测血压。移植物输注通过标准输血过滤器进行，各份之间有间隔。输注开始后，频繁给予利尿剂（同种异体BMT和自体BMT受者分别为40%和40%）以避免液体过载。自体BMT患者更频繁地观察到非心血管临床毒性（41%对6%，p = 0.02），且在任何测量的心血管参数方面，自体移植物和同种异体移植物受者之间均未观察到显著差异。两组心率均略有下降，但两组均无患者心率<60次/分钟或出现心脏传导阻滞。两组血压均未检测到显著变化。自体BMT组移植物输注后室性异位搏动/房性异位搏动比值升高（0.7对0，p = 0.1）。植入时间与其他已发表系列相比无显著差异。我们的结果表明，延长冷冻保存材料的输注时间并使用标准过滤器可能会降低与输注冷冻保存移植物相关的毒性。早期给予利尿剂可能有助于更好地控制血压。
