PROPHYLACTIC EFFICACY OF WASHED CORD BLOOD AGAINST ANAPHYLAXIS ASSOCIATED WITH CORD BLOOD TRANSPLANTATION: A CASE REPORT

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  • 臍帯血移植時のアナフィラキシー対策として洗浄臍帯血が有効であった1例

Abstract

<p>We report the successful prevention of recurrent anaphylaxis with washed cord blood (CB) at second cord blood transplantation (CBT) in a patient who experienced severe anaphylactic events during infusion at the first CBT.</p><p>A Japanese woman in her 30s diagnosed with acute myelogenous leukemia (AML) received the first CBT (nucleated cell count (NCC) 1.72×107/kg). When the approximate 80% compartment of the CB unit was infused, anaphylaxis with dyspnea, hypoxia and hypotension occurred. The infusion was immediately stopped and she was treated with intramuscular injection of epinephrine. Although the remaining 20% portion was not infused, engraftment was achieved at day 25 after transplantation. At 18 months after the first CBT, retransplantation was planned for AML relapse using washed CB to prevent recurrence of anaphylaxis. After one CB unit (NCC 3.20×107/kg) was thawed in a 37°C water bath, it was slowly diluted with a solution containing albumin and dextran (ALB/D) and centrifuged while cooling. The supernatant was removed, and the ALB/D solution was added to a final volume of 50ml. The washed CB was infused into the patient as soon as possible. No anaphylactic reaction was observed, and CB cells were successfully engrafted at day 13 after the second CBT.</p>

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