Pericardial effusion after pediatric hematopoietic cell transplant

Osamah Aldoss, Daniel H. Gruenstein, John L. Bass, Julia Steinberger, Yan Zhang, Todd E. Defor, Jakub Tolar, Michael R. Verneris, Paul J. Orchard

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

PE can occur following HCT. However, the incidence, etiology, risk factors, and treatment remain unclear. We performed a retrospective study evaluating 355 pediatric recipients of HCT treated at a single institution between January 2005 and August 2010. No cases of PE were identified in the autologous HCT (auto-HCT) recipients (0/43), while 19% (57/296) of allogeneic HCT (allo-HCT) developed PE. Among the 57 PE patients, 40 (70%) were males; the median age at transplantation was 6.6 yr (0.1-17.3 yr). Thirty-six patients (63%) had significant PE with 23 patients (40%) treated by pericardiocentesis, and 19 (33%) experiencing recurrent PE. OS rates for patients who developed PE were 84% at 100 days and 65% at three yr after HCT. Risk factors associated with PE on multivariate analysis included myeloablative conditioning (p = 0.01), delayed neutrophil engraftment (p < 0.01), and CMV + serostatus of the recipient (p = 0.03). Recipients with non-malignant diseases were significantly less likely to die after development of PE (p = 0.02 and 0.004 when comparing with standard and high-risk diseases, respectively). In summary, PE is a common and significant complication of pediatric allo-HCT. Prospective studies are needed to better determine the etiology and optimal method of PE treatment after HCT.

Original languageEnglish (US)
Pages (from-to)294-299
Number of pages6
JournalPediatric transplantation
Volume17
Issue number3
DOIs
StatePublished - May 2013

Keywords

  • delayed engraftment
  • hematopoietic cell transplant
  • myeloablative conditioning
  • pericardial effusion

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