IMPACT OF HEMATOPOIETIC CELL TRANSPLANTATION FOR HEMATOLOGICAL DISEASE ON BLOOD PRESSURE AND HEART RATE

Aim: Monitoring of blood pressure and heart rate during hematopoietic cell (HC) graft infusion and assessment of influence of cryopreservation agent dimethylsulfoxide (DMSO).
Patients and methods: 153 HC graft infusions in 153 consecutive hematological patients were evaluated. The patients consisted of 80 males and 73 females with the mean age of 49.1±12.6 years. 42 patients were treated for arterial hypertension and were well compensated before HC transplantation. Cryopreservation with DMSO was used in 133 grafts (DMSO group), 20 grafts were infused directly without cryopreservation (control group). 115 grafts were autologous and 38 allogeneic. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured immediately before and after HC graft infusion. 
Results: SBP and DBP significantly increased after graft infusion cryopreserved with DMSO – SBP from 122.3±17.9mmHg to 127.7±18.1mmHg (p<0.0001), DBP from 70.9±12.3mmHg to 74.1±12.6mmHg (p<0.01). Changes in HR were not significant in DMSO group. Increase in BP and HR correlated with increasing DMSO dose. In the control group, changes in SBP, DBP and HR were not significant. Changes in BP and HR were not significantly different in patients treated for arterial hypertension and other patients.
Conclusions: Our results show that HC graft infusion cryopreserved with DMSO caused statistically significant increase in SBP and DBP. Increase more than 10 mmHg was seen in 31.6 %, respectively 23.3 % patients. Changes in HR were not statistically significant. These changes were mostly transient and asymptomatic and did not require therapeutic intervention. However, they may cause complications, especially in patients with preexisting cardiovascular disease. These patients should be observed closely during HC transplantation.
Supported by Research Project MO 0FVZ 0000 503.