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Heparin toxicity following allogeneic bone marrow infusion

Bone Marrow Transplantation volume 41, pages 585–586 (2008)Cite this article

The infusion of non-cryopreserved allogeneic BM is usually well tolerated. If infusion-related complications do occur, they are generally mild. In one study of 71 patients, the only reported side effects were nausea (14%), vomiting (8.5%) and chills (1.4%).1 In a smaller study with fifteen patients, only one (6%) experienced mild side effects.2 Despite infusion of seventeen BM autografts and allografts contaminated with common skin bacteria, no immediate toxicity developed in the recipients.3 In rare instances, serious events such as transfusion-related acute lung injury occur.4 We report prolonged bleeding in a transplant recipient caused by heparin added to the donor's harvested BM.

A 47-year-old diabetic woman, weighing 90.5 kg, with no previous history of abnormal bleeding was diagnosed with acute myelogenous leukemia (subtype M2). She was treated with two courses of cytarabine 3 g/m2 every 12 h on days 1–6 and idarubicin 12 mg/m2 on days 1–3 and achieved a CR after the first course. She subsequently received a myeloablative matched-sibling BMT after conditioning with fludarabine and BU. A total of 930 ml of BM anticoagulated with heparin sodium was infused over 84 min. Because of diabetes mellitus, her glucose was checked by the finger-stick method 90 min after the marrow infusion was completed. She bled continuously from the finger-stick for a total of 4 h.

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References

  1. Stroncek DF, Fautsch SK, Lasky LC, Hurd DD, Ramsay NKC, McCullough J . Adverse reactions in patients transfused with cryopreserved marrow. Transfusion 1991; 31: 521–526.

    Article  CAS  Google Scholar 

  2. López-Jiménez J, Cerveró C, Muñoz A, Hernández-Madrid A, Fernández Pineda J, García Laraña J et al. Cardiovascular toxicities related to the infusion of cryopreserved grafts: results of a controlled study. Bone Marrow Transplant 1994; 13: 789–793.

    PubMed  Google Scholar 

  3. Rowley SD, Davis J, Dick J, Braine HG, Charache P, Saral R et al. Bacterial contamination of bone marrow intended for autologous and allogeneic bone marrow transplantation: incidence and clinical significance. Transfusion 1988; 28: 109–112.

    Article  CAS  Google Scholar 

  4. Urahama N, Tanosaki R, Masahiro K, Iijima K, Chizuka K, Kim SW et al. TRALI after the infusion of marrow cells in a patient with acute lymphoblastic leukemia. Transfusion 2003; 43: 1553–1557.

    Article  Google Scholar 

  5. Areman EM, Deeg HJ, Sacher RA . Bone Marrow and Stem Cell Processing: A Manual of Current Techniques. FA Davis Company: Philadelphia, 1992.

    Google Scholar 

  6. National Marrow Donor Program (NMDP) 19th Edition Standards; June 23 2004.

  7. Thomas ED, Storb R . Technique for human marrow grafting. Blood 1970; 36: 507–515.

    CAS  PubMed  Google Scholar 

  8. de Swart CAM, Nijmeyer B, Roelofs JMM, Sixma JJ . Kinetics of intravenously administered heparin in normal humans. Blood 1982; 60: 1251–1258.

    CAS  PubMed  Google Scholar 

  9. Bentley PG, Kakkar VV, Scully MF, MacGregor IR, Webb P, Chan P et al. An objective study of alternative methods of heparin administration. Thromb Res 1980; 18: 177–187.

    Article  CAS  Google Scholar 

  10. Salzman EW, Deykin D, Shapiro RM, Rosenberg R . Management of heparin therapy: controlled prospective trial. N Engl J Med 1975; 292: 1046–1050.

    Article  CAS  Google Scholar 

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  1. Division of Hematology and Oncology, Department of Internal Medicine, Saint Louis University School of Medicine, St Louis, MO, USA

    M J Williamson Jr, G C Kudva & S M Pincus

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  1. M J Williamson Jr
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  2. G C Kudva
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  3. S M Pincus
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Correspondence to G C Kudva.

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Williamson, M., Kudva, G. & Pincus, S. Heparin toxicity following allogeneic bone marrow infusion. Bone Marrow Transplant 41, 585–586 (2008). https://doi.org/10.1038/sj.bmt.1705936

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