Engraftment syndrome in children undergoing autologous peripheral blood progenitor cell transplantation

Madero, Luís; Vicent, M. González; Sevilla, Julián; Prudencio, Marta; Rodríguez, Federico Álvarez; Díaz, Miguel Ángel

doi:10.1038/sj.bmt.1703645

Cited by 31 publications

(31 citation statements)

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“…1 We now present here the largest prospective study of ES after autologous PBPCT in pediatric patients. In 1995, Lee et al 5 described ES as the presence of skin rash and noninfectious neutropenic fever in the periengraftment period.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, the reported incidence has varied widely in part due to the lack of uniform diagnostic criteria. [2][3][4] This has also influenced the analysis of risk factors for ES.…”

mentioning

confidence: 99%

“…2 We also retrospectively analyzed risk factors for ES and found that the mobilization regimen used was the only variable significantly associated with ES: patients mobilized with high doses of G-CSF in steadystate hematopoiesis had a higher incidence of ES. 1 In order to gain more information in this setting of patients regarding this post transplant event, we prospectively analyzed the incidence, risk factors and clinical outcome of ES in pediatric patients undergoing autologous PBPCT.…”

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confidence: 99%

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Engraftment syndrome after autologous peripheral blood progenitor cell transplantation in pediatric patients: a prospective evaluation of risk factors and outcome

González‐Vicent

Ramı́rez

Sevilla

et al. 2004

Bone Marrow Transplant

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Summary:We prospectively analyzed the incidence, risk factors and outcome of engraftment syndrome (ES) in 112 patients undergoing autologous peripheral blood progenitor cell transplantation with different malignancies between January 1999 and December 2003. The median age was 8 years (range 1-18). There were 73 males. There were 37 hematological neoplasias and 75 solid tumors. Disease status at transplantation was early in 49, intermediate in 15 and 48 in advanced phase. The median CD34 þ cells infused was 4.6 Â 10 6 /kg. With a median follow-up of 23 months (1-116 months), 38 patients developed ES. The cumulative incidence of ES was 34.574.5% and the event-free survival was 58.3712%. There were no differences in the causes of death between patients with or without ES. A high number of CD34 þ cells/kg infused, patients transplanted in early phase, the type of malignancy (solid tumor) and conditioning regimens other than busulfan based were significantly associated with ES in a multivariate analysis.

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Section: Discussionmentioning

confidence: 99%

“…1 However, the reported incidence has varied widely in part due to the lack of uniform diagnostic criteria. [2][3][4] This has also influenced the analysis of risk factors for ES.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Engraftment syndrome after autologous peripheral blood progenitor cell transplantation in pediatric patients: a prospective evaluation of risk factors and outcome

González‐Vicent

Ramı́rez

Sevilla

et al. 2004

Bone Marrow Transplant

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“…There are also conflicting data regarding an association between ES, NRM and survival. 1,2,[10][11][12][13][14][15] Some of these discordances likely reflect different definitions of ES.…”

Section: Introductionmentioning

confidence: 99%

Engraftment syndrome: double-edged sword of hematopoietic cell transplants

Spitzer

2015

Bone Marrow Transplant

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Engraftment syndrome (ES) after hematopoietic cell transplantation (HCT) is increasingly diagnosed. Common features include fever, pulmonary vascular leak, rash and organ dysfunction. Different diagnostic criteria likely account for the wide (7-90%) range of reported incidences. ES typically occurs within 4 days of granulocyte recovery although a recently described seemingly similar syndrome occurs 41 week before granulocyte recovery after umbilical cord blood cell transplants. Although the clinical manifestations of ES may be identical to those of acute GVHD, ES also has been well described in patients without acute GVHD. The data are conflicting as to whether ES is associated with a higher nonrelapse mortality and worse survival after HCT. The pathophysiology of ES is unclear, but endothelial injury and activated granulocytes in the setting of proinflammatory cytokines may be important. ES typically is self-limited, but, like acute GVHD, responds to corticosteroids. Because ES and acute GVHD may have overlapping features and response to therapy, these disease processes may often not be distinct events. Moreover, features of ES may overlap with those of drug-and radiation-induced toxicities and infection. Further research to better characterize the clinical spectrum and etiology of ES and to determine its relationship to GVHD is needed.

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“…94 Furthermore, mobilization with high-dose G-CSF (12 mg/kg s.c. twice daily, beginning 4 days before apheresis and continuing until the end of apheresis) has been reported to increase the risk for development of engraftment syndrome in children who are undergoing mobilization for auto-HSCT to treat hematological malignancies or solid tumors. 95 GM-CSF plus G-CSF Significant synergism has been reported between GM-CSF and G-CSF in the formation of granulocytic colonies in vitro. 96 Mobilization regimens combining GM-CSF with G-CSF have consisted of sequential or concurrent administration of these agents at a range of doses (G-CSF, 5-10 mg/kg; GM-CSF, 5 mg/kg-250 mg/m 2 ), with or without chemotherapeutic agents.…”

Section: Mobilization Agent Mechanismmentioning

confidence: 99%