Toxicities of Mobilized Stem Cell Infusion

Infusion of bone marrow or cytokine mobilized stem cells can be associated with severe and potentially life-threatening toxicities. The etiology of the toxicities can be related to volume of infusion, dimethylsulfoxide (DMSO) or bacterial or viral infection of the infused cell products. Serious toxicities including hypotension and hypertension, cardiac arrhythmias, and respiratory failure require the prompt attention by a trained physician. Non-life-threatening toxicities are common and include fever, chills, nausea and vomiting. Fever may be caused by an infection or cytokines released from leukocytes in the hematopoietic cell product. Other possible adverse events can be attributed to the reagents used in the processing procedure. Monitoring and management of toxicities and the roles of nurses, technicians, and physicians are outlined below.