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Post-Transplant Events

Large pericardial effusion as a complication in adults undergoing SCT

Bone Marrow Transplantation volume 46, pages 1353–1356 (2011)Cite this article

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Abstract

Large pericardial effusion (LPE) leading to cardiac tamponade is a rare complication described in patients undergoing SCT. This complication is considered to be a manifestation of chronic GVHD; however its pathophysiology is poorly understood. Currently, there are no published data systematically describing the incidence, clinical characteristics and outcomes of LPEs in adult stem cell transplant recipients. We retrospectively evaluated 858 adult patients (512 autologous, 148 related and 198 unrelated donor) who underwent hematopoietic stem cell and BM transplants at our institution from 2005 to 2008 for the development of post transplant LPE. Seven patients (0.8%) were found to have LPEs and all these patients had undergone unrelated allografts. The median day of diagnosis post transplant was 229 (range 42–525). None of these patients had active manifestations of GVHD other than serositis at the time of LPE detection. Pericardial window (PW) was successfully placed in all patients who developed cardiac tamponade and most patients with LPE were effectively treated by increasing immunosuppression. We conclude that LPE is a rare late complication after allogeneic transplant in adults and in our study developed only after unrelated transplant. PW can be safely performed in these patients and LPEs can be successfully treated with intensification of systemic immunosupression.

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References

  1. Murdych T, Weisdorf DJ . Serious cardiac complications during bone marrow transplantation at the University of Minnesota, 1977–1997. Bone Marrow Transplant 2001; 28: 283–287.

    Article  CAS  Google Scholar 

  2. Cahill RA, Spitzer TR, Mazumder A . Marrow engraftment and clinical manifestations of capillary leak syndrome. Bone Marrow Transplant 1996; 18: 177–184.

    CAS  PubMed  Google Scholar 

  3. Ratanatharathorn V, Ayash L, Lazarus HM, Fu J, Uberti JP . Chronic graft-versus-host disease: clinical manifestation and therapy. Bone Marrow Transplant 2001; 28: 121–129.

    Article  CAS  Google Scholar 

  4. Silberstein L, Davies A, Kelsey S, Foran J, Murrell C, D'Cruz D et al. Myositis, polyserositis with a large pericardial effusion and constrictive pericarditis as manifestations of chronic graft-versus-host disease after non-myeloablative peripheral stem cell transplantation and subsequent donor lymphocyte infusion. Bone Marrow Transplant 2001; 27: 231–233.

    Article  CAS  PubMed  Google Scholar 

  5. Toren A, Nagler A . Massive pericardial effusion complicating the course of chronic graft-versus-host disease (cGVHD) in a child with acute lymphoblastic leukemia following allogeneic bone marrow transplantation. Bone Marrow Transplant 1997; 20: 805–807.

    Article  CAS  PubMed  Google Scholar 

  6. Cereda M, Trocino G, Pogliani EM, Schiavina R . A case of cardiac localization of graft-versus-host disease after allogenic bone marrow transplantation. Ital Heart J 2003; 4: 60–63.

    PubMed  Google Scholar 

  7. Rhodes M, Lautz T, Kavanaugh-Mchugh A, Manes B, Calder C, Koyama T et al. Pericardial effusion and cardiac tamponade in pediatric stem cell transplant recipients. Bone Marrow Transplant 2005; 36: 139–144.

    Article  CAS  PubMed  Google Scholar 

  8. Martin RP, Rakowski H, French J, Popp RL . Localization of pericardial effusion with wide angle phased array echocardiography. Am J Cardiol 1978; 42: 904–912.

    Article  CAS  PubMed  Google Scholar 

  9. Ueda T, Manabe A, Kikuchi A, Yoshino H, Ebihara Y, Ishii T et al. Massive pericardial and pleural effusion with anasarca following allogeneic bone marrow transplantation. Int J Hematol 2000; 71: 394–397.

    CAS  PubMed  Google Scholar 

  10. Angelucci E, Mariotti E, Lucarelli G, Baronciani D, Cesaroni P, Durazzi SM et al. Sudden cardiac tamponade after chemotherapy for marrow transplantation in thalassaemia. Lancet 1992; 339: 287–289.

    Article  CAS  PubMed  Google Scholar 

  11. Veys PA, McAvinchey R, Rothman MT, Mair GH, Newland AC . Pericardial effusion following conditioning for bone marrow transplantation in acute leukaemia. Bone Marrow Transplant 1987; 2: 213–216.

    CAS  PubMed  Google Scholar 

  12. Krishnan GS, Chaudhary V, Al-Janadi A, Ramanarayanan J, D’Silva KJ . BCNU toxicity presenting with a large pericardial and pleural effusion. Ann Transplant 2008; 13: 44–47.

    PubMed  Google Scholar 

  13. Perez Retortillo JA, Marco F, Richard C, Conde E, Manjon R, Bureo E et al. Pneumococcal pericarditis with cardiac tamponade in a patient with chronic graft-versus-host disease. Bone Marrow Transplant 1998; 21: 299–300.

    Article  CAS  PubMed  Google Scholar 

  14. Walsh TJ, Bulkley BH . Aspergillus pericarditis: clinical and pathologic features in the immunocompromised patient. Cancer 1982; 49: 48–54.

    Article  CAS  PubMed  Google Scholar 

  15. Seber A, Khan SP, Kersey JH . Unexplained effusions: association with allogeneic bone marrow transplantation and acute or chronic graft-versus-host disease. Bone Marrow Transplant 1996; 17: 207–211.

    CAS  PubMed  Google Scholar 

  16. Lechapt-Zalcman E, Rieux C, Cordonnier C, Desvaux D . Posttransplantation lymphoproliferative disorder mimicking a nonspecific lymphocytic pleural effusion in a bone marrow transplant recipient. A case report. Acta Cytol 1999; 43: 239–242.

    Article  CAS  PubMed  Google Scholar 

  17. Cavet J, Lennard A, Gascoigne A, Finney RD, Lucraft HH, Richardson C et al. Constrictive pericarditis post allogeneic bone marrow transplant for Philadelphia-positive acute lymphoblastic leukaemia. Bone Marrow Transplant 2000; 25: 571–573.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Wayne State University School of Medicine, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA

    M Norkin, V Ratanatharathorn, L Ayash, M H Abidi, Z Al-Kadhimi, L G Lum & J P Uberti

  2. University of Florida College of Medicine, Gainesville, FL, USA

    M Norkin

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  1. M Norkin
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  2. V Ratanatharathorn
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Correspondence to M Norkin.

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Norkin, M., Ratanatharathorn, V., Ayash, L. et al. Large pericardial effusion as a complication in adults undergoing SCT. Bone Marrow Transplant 46, 1353–1356 (2011). https://doi.org/10.1038/bmt.2010.297

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