Adverse effects of cell-free and concentrated ascites reinfusion therapy for malignant ascites: a single-institute experience.

Abstract

BACKGROUND:

Cell-free and concentrated ascites reinfusion therapy (CART) is a strategy for improving various intractable symptoms due to refractory ascites, including hypoalbuminemia. CART has recently been applied in the treatment of cancer patients. This study was performed to assess the safety of CART in a single cancer institute.

METHODS:

We retrospectively reviewed 233 CART procedures that were performed for 132 cancer patients in our institute.

RESULTS:

The median weight of ascites before and after concentration was 4,720 g and 490 g (median concentration rate, 10.0-fold), The median amounts of total protein and albumin were 64.0 g and 32.6 g (median recovery rates, 44.9% and 49.0%), respectively. Thirty-three adverse events (AEs) were observed in 22 (9.4%) of 233 procedures; 30 of these events occurred after reinfusion. The most common reinfusion-related AEs were fever (13 events) and chills (10 events). Univariate analyses revealed no significant relationships between the frequency of AEs and age, sex, appearance of ascites, weight of harvested and concentrated ascites, the ascites processing rate (filtration and concentration), weight of saline used for membrane cleaning, amount of calculated total protein for infusion, or prophylaxis against AEs; the reinfusion rate of ≥ 125 mL/h or ≥ 10.9 g/h of total protein affected the frequency of AEs, regardless of the prophylactic use of steroids.

CONCLUSIONS:

The observed AEs were mainly mild reactions after reinfusion, which were related to a reinfusion rate of volume ≥ 125 mL/h, a simple indicator in practice, or total protein ≥ 10.9 g/h. Although our study was retrospective in nature and undertaken in a single institute, this information may be helpful for the management of cancer patients with refractory malignant ascites using CART.

• Authors: Misato Tsubokura, Yuko Adegawa, Minoru Kojima, Ryuji Tanosaki, Ryuzaburo Ohtake, Yuki Kase, Nao Iwashita, Moemi Kasane, Saori Nakabayashi, Sayaka Takeuchi, Ken Kato, Narikazu Boku, Yukihide Kanemitsu, Takuji Okusaka, Hiroyuki Fujimoto, Kan Yonemori, Hiroto Ishiki, Kimihiko Kawamura, Eriko Satomi, Hiromichi Matsushita
• Journal: BMC cancer (BMC Cancer) Vol. 22 Issue 1 Pg. 268 (Mar 14 2022) ISSN: 1471-2407 [Electronic] England
• PMID: 35287609 (Publication Type: Evaluation Study, Journal Article)
• Copyright: © 2022. The Author(s).

Topics

• Adult
• Aged
• Aged, 80 and over
• Ascites (etiology, mortality, therapy)
• Cell- and Tissue-Based Therapy (methods, mortality)
• Cell-Free System
• Cross-Sectional Studies
• Digestive System Neoplasms (complications)
• Female
• Humans
• Infusions, Parenteral
• Male
• Middle Aged
• Retrospective Studies
• Treatment Outcome