CARDIOVASCULAR TOXICITIES RELATED TO THE INFUSION OF CRYOPRESERVED GRAFTS - RESULTS OF A CONTROLLED-STUDY

To evaluate cardiovascular toxicities associated with the infusion of cryopreserved grafts, we prospectively monitored the infusions of 29 a utologous 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 st art of graft infusion until 24 h after completion, Blood pressure was closely monitored during the same period. Graft infusions were perform ed 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 respectively) to avoid fluid overload. vascular clinical toxicities were observed more frequently i n autologous BMT patients (41% vs 6%, p = 0.02) and no significant dif ferences were seen between autograft and allograft recipients in any o f the measured cardiovascular parameters. The heart rate decreased sli ghtly in both groups but no patient in either group had a heart rate o f < 60 b.p.m. or heart block. No significant changes in blood pressure were detected in either group. Ventricular ectopic beats/atrial ectop ic beats ratio increased in the autologous BMT group after graft infus ion (0.7 vs 0, p = 0.1). Time to engraftment did not differ significan tly from other published series. Our results suggest that increasing i nfusion time of cryopreserved material and using a standard filter may reduce toxicities associated with the infusion of cryopreserved graft s. Early administration of diuretics may contribute to better control of blood pressure.