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Pericardial effusion post transplantation predicts inferior overall survival following allo-hematopoietic stem cell transplant

Bone Marrow Transplantation volume 51, pages 303–306 (2016)Cite this article

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Hematopoietic stem cell transplant (HSCT) is an established therapy for various malignant and nonmalignant disorders in adults. Despite significant improvement in supportive care, HSCT continues to be associated with significant morbidity and mortality. Pericardial effusion (PE) is a known complication of HSCT that can result in significant morbidity and even death by causing acute cardiac tamponade.1, 2 The exact incidence and risk factors are not well established, but retrospective reviews report PE occurring in 0.2–19% of HSCT patients.1, 3, 4 Age, gender, disease risk, conditioning regimen, neutrophil engraftment, relapse, GVHD, GVHD prophylaxis, donor type and CMV viremias have been suggested as potential risk factors.1, 4, 5, 6, 7 The initial symptoms of PE can be non-specific, thus early recognition of PE may allow us to further optimize care and improve outcomes.

In our retrospective clinical practice, we observed that patients receiving a myeloablative conditioning regimen were more likely to develop early pericardial effusion (PE) (within 100 days of transplantation) in auto-hematopoietic stem cell transplant (auto-HSCT). Patients who relapsed were more likely to have early PE in allo-HSCT. Patients with longer neutrophil engraftment using immunosuppressive drugs other than cyclosporine were more likely to develop late-onset PE (beyond 100 days post transplantation) in allo-HSCT. Patients with PE tend to have inferior overall survival (OS) and higher treatment-related mortality (TRM) than patients without PE. Death rate due to infection or GVHD was higher in PE patients than those without PE.

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Acknowledgements

This research was supported by grant from the National Science Foundation of China (grant nos. 30971293 and 81300390).

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Authors and Affiliations

  1. Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    X Chen, Q Zou, J Yin, C Wang, J Xu, J Wei & Y Zhang

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  1. X Chen
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Correspondence to J Wei or Y Zhang.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Chen, X., Zou, Q., Yin, J. et al. Pericardial effusion post transplantation predicts inferior overall survival following allo-hematopoietic stem cell transplant. Bone Marrow Transplant 51, 303–306 (2016). https://doi.org/10.1038/bmt.2015.227

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