Complications of stem cell infusion

• Microemboli occasionally cause dyspnoea and cyanosis. O2 should be available. Slow down or stop the stem cell infusion if dyspnoea.

• Pyrexia, rash and rigors can occur—treat with hydrocortisone 100mg IV and chlorpheniramine 10mg IV.

• Hypertension may occur (especially if patient fluid overloaded). Usually responds to diuretic.

►► Acute anaphylaxis is very rare but adrenalin (1mL of 1:1000 ) should be available in the patient's room for SC or IM administration.

Daily ward management

Each day check patient for

• Nausea and vomiting.

• Skin surveillance needed to observe for signs of acute and chronic GvHD, HSV, HZV and drug related problems.

• Hickman line infections are common post-transplant. If any signs of infection and fever, line cultures and exit site swab should be taken. Remove line as soon as infusional support no longer needed.

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