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Peripheral Blood Stem Cells

Engraftment syndrome in children undergoing autologous peripheral blood progenitor cell transplantation

Bone Marrow Transplantation volume 30, pages 355–358 (2002)Cite this article

Abstract

There is limited experience on engraftment syndrome (ES) in children. The present study analyzes the characteristics of ES in pediatric patients undergoing autologous peripheral blood progenitor cells transplantation (PBPCT). From 1993 to 2001, 30 of 156 patients (19.2%) who underwent PBPCT developed ES (skin rash which involved more than 27% of the body surface and temperature >38.3°C with no compatible infectious disease etiology, during neutrophil recovery). Of the 30 patients who developed ES, 20 (66%) developed hypoxia and/or pulmonary infiltrates, seven (23%) had hepatic dysfunction, six (20%) developed renal insufficiency, 16 (53%) showed weight gain and three (10%) experienced transient encephalopathy. Multivariate analysis showed that the only positive predictive factor for developing ES was mobilization with high-dose G-CSF (12 μg/kg twice daily) (RR 3.88, CI 95% 1.73–8.67; P < 0.0005). The overall transplant-related mortality (TRM) was 8.33% and this was significantly higher in the patients who developed ES than in those who did not (23% vs 4.76%; P < 0.0001). We also found a higher morbidity in patients who developed ES, expressed as a statistically significant increase in supportive care (transfusion requirement, parenteral nutrition) and increase in the length of hospital stay. In summary, we have found ES to be the most important cause of morbidity and mortality in children undergoing autologous PBPCT.

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Authors and Affiliations

  1. Department of Pediatric Hematology and Oncology, Hospital Infantil Niño Jesús, Madrid, Spain

    L Madero, MG Vicent, J Sevilla, M Prudencio, F Rodríguez & MA Díaz

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  1. L Madero
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  2. MG Vicent
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  3. J Sevilla
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  4. M Prudencio
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  5. F Rodríguez
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  6. MA Díaz
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Madero, L., Vicent, M., Sevilla, J. et al. Engraftment syndrome in children undergoing autologous peripheral blood progenitor cell transplantation. Bone Marrow Transplant 30, 355–358 (2002). https://doi.org/10.1038/sj.bmt.1703645

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