Umbilical Cord Blood Infusion Reactions

Methods Through an EAP (IND# 15949), children with autism spectrum disorder (ASD), cerebral palsy (CP), and related brain injuries undergo CB infusion with autologous or sibling (≥3/6 human leukocyte antigen [HLA] match) CB. Data regarding infusion reactions in this population were obtained from a REDCap (Research Electronic Data Capture, hosted at Duke University) database and clinical records. 1 TablePatient, umbilical cord blood unit, and treatment characteristics Characteristic Autologous (n = 21) Sibling (n = 17) Total (n = 38) Patient characteristics Age, median (range) 6.83 (2.08‐9.75) 6.75 (4.0‐15.5) 6.8 (2.1‐15.5) Diagnosis Autism spectrum disorder 20 (95.2%) 12 (70.5%) 32 (86.5%) Cerebral palsy 1 (4.8%) 5 (29.5%) 6 (15.7%) Known allergies Medication 4 (19%) 4 (23.5%) 8 (21%) Food 9 (42.8%) 5 (29.4%) 14 (36.8%) Cord blood characteristics Thawed TNCC (×107/kg), median (range) 2.4 (0.9‐4.5) 2.6 (1.01‐5.6) 2.6 (0.9‐5.6) HLA match 6/6 21 (100%) 7 (41.2%) 28 (73.7%) 4/6 – 3 (17.6%) 3 (7.9%) 3/6 – 7 (41.2%) 7 (18.4%) Infusion successfully completed 17 (80.9%) 8 (47.1%) 25 (65.7%) Infusion reaction characteristics CTCAE Grade 1 11 (52.4%) 3 (17.6%) 14 (36.8%) 2 5 (23.8%) 11 (64.7%) 16 (42.1%) 3 5 (23.8%) 3 (17.6%) 8 (21%) 4 0 (0%) 0 (0%) 0 (0%) Symptoms Allergy/hypersensitivity 20 (95.2%) 17 (100%) 37 (97.4%) Tachycardia 2 (9.5%) 3 (17.6%) 5 (13.5%) Hypotension 0 (0%) 2 (11.8%) 2 (5.3%) Hypoxia 3 (14.3%) 6 (35.3%) 9 (23.7%) Rash 2 (9.5%) 3 (17.6%) 5 (13.5%) Nausea/Vomiting 0 (0%) 2 (11.8%) 2 (5.3%) Treatment IV diphenhydramine 19 (90.5%) 15 (88.2%) 34 (89.5%) IV methylprednisolone 5 (23.8%) 10 (58.8%) 15 (39.5%) Inhaled albuterol 5 (23.8%) 8 (47%) 13 (34.2%) Oxygen 2 (9.5%) 3 (17.6%) 5 (13.2%) Other steroid 2 (9.5%) 3 (17.6%) 5 (13.2%) Epinephrine 0 1 (5.9%) 1 (2.6%) Discussion While CB infusion is generally safe, there is a real risk of infusion reactions requiring additional medical treatment.