engleski

Allergic reaction during reinfusion of autologous bone marrow related to treatment of Hodgkin's lymphoma ; possible role of hydroxyethyl starch : a case report

The present paper reports a case of anaphylactic reaction to hydroxyethyl starch (HES) that occurred during the reinfusion of autologous bone marrow in a patient treated for malignant lymphoma. After thawing, the contents of the packs was reinfused briskly through a central venous line. A severe anaphylactic reaction occurred during the reinfusion of the first 50 ml pack that was processed using HES. The patient reported pruritus and carpal spasm. Edema and erythema of the hands were also present together with hypotension and tachycardia. Due to close time relation between the infusion of bone marrow processed by HES density gradient and the occurrence of signs and symptoms, we believe that the anaphylactic reaction in our patient resulted from a very small amount of HES present in the processed bone marrow autograft. The use of HES is accompanied with a low incidence of severe allergic reactions. Cases have been reported with hypotension, urticaria and angioedema, however without bronchospasm. Our patient was treated with reinfusion of bone marrow processed by HES density gradient. In spite of the small quantity of HES that was used, a severe anaphylactic reaction occurred. Even though such reactions have an extremely low incidence, clinicians should be aware of that possibility, and also of treatment options.

hydroxyethyl starch; anaphylaxis; autologous bone marrow transplantation

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