Pericardial effusion post-SCT in pediatric recipients with signs and/or symptoms of cardiac disease

Neier, Michelle; Jin, Zhezhen; Kleinman, Charles S.; Baldinger, L.; Bhatia, Monica; Silver, Eric S.; Ven, Carmella van de; Morris, Erin; Satwani, Prakash; George, Diane; Garvin, James H.; Bradley, M.B.; Schwartz, Joseph; Cairo, Mitchell S.

doi:10.1038/bmt.2010.149

Cited by 32 publications

(50 citation statements)

References 24 publications

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“…One study found no cases of pericardial effusion following autologous HSCT . In contrast, several reports have demonstrated the occurrence of pericardial effusion after autologous HSCT consistent with our result . Thus, in addition to onset frequency, clinical characteristics are also heterogeneous across studies, possibly due to influences of uncontrolled variables such as patient disease, transplant conditions, and post‐treatment complications.…”

Section: Discussionsupporting

confidence: 88%

Pretransplant-corrected QT dispersion as a predictor of pericardial effusion after pediatric hematopoietic stem cell transplantation

et al. 2015

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SummaryPericardial effusion is a potentially fatal complication following hematopoietic stem cell transplantation (HSCT). Therefore, the identification of risk factors could improve the outcome. Prolonged QT dispersion (QTD) and corrected QTD (QTcD) are associated with serious arrhythmias and sudden death in many forms of heart disease. However, no study has evaluated the efficacy of QTD and QTcD to predict pericardial effusion post-HSCT. We studied 89 pediatric HSCT patients to identify preoperative risk factors for pericardial effusion with particular focus on QTD and QTcD. Pericardial effusion occurred in 15 patients (cumulative onset rate: 17.4%) within one year post-HSCT, of which 8 (9.2%) were symptomatic. Patients with pericardial effusion following allogeneic HSCT showed significantly lower overall survival; however, pericardial effusion was not the direct cause of death in any patient. Univariate and multivariate analyses revealed that transplantation-associated thrombotic microangiopathy (TA-TMA) was an independent risk factor for post-HSCT pericardial effusion. In addition, pretransplant QTcD was significantly prolonged in the pericardial effusion group. These results suggest that pediatric patients with abnormally prolonged QTcD before the preparative regimen for HSCT should be regularly followed-up by echocardiography to detect pericardial effusion, particularly when accompanied by complications including TA-TMA.

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Section: Discussionsupporting

confidence: 88%

Pretransplant-corrected QT dispersion as a predictor of pericardial effusion after pediatric hematopoietic stem cell transplantation

et al. 2015

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“…2 An allogeneic donor source, GVHD, infection, relapsed malignant disease, highrisk status, myeloablative conditioning, and TBI have been reported as risk factors for developing pericardial effusion. 1 The causes of pericardial effusion after HSCT have been reported as cyclophosphamide, 3 cytosine arabinoside, 4 TBI, 5 engraftment syndrome, 6 GVHD, 7 and infection. 8 Cardiac complications associated with HHV-6 were reported in just 2 cases.…”

Section: Figure 1 Computed Tomography Scan Taken On Day 28mentioning

confidence: 99%

“…Although rarely encountered, these complications can be lifethreatening. 1,2 Possible causes of cardiac damage in these patients have been reported to be cyclophosphamide, 3 cytosine arabinoside, 4 total body irradiation (TBI), 5 engraftment syndrome, 6 graft-versus-host disease (GVHD), 7 and infection. 8 However, cardiac complications associated with human herpesvirus-6 (HHV-6) have been reported in just 2 cases.…”

Section: Introductionmentioning

confidence: 99%

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Yoshida

Nakamae²,

Okamura³

et al. 2017

Exp Clin Transplant

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A 53-year-old woman with myelodysplastic syndrome received a cord blood transplant because she had frequent episodes of febrile neutropenia. As a conditioning regimen for transplant, she received 12 Gy total body irradiation, intravenous cytosine arabinoside 3 g/m 2 every 12 hours on days -5 and -4, and cyclophosphamide 60 mg/kg/day on days -3 and -2. She received tacrolimus and short-term methotrexate treatment as prophylaxis for graftversus-host disease. Her cardiac function was normal before transplant. She developed acute heart failure with a mild pericardial effusion 11 days after transplant, but her failure improved with a diuretic, vasodilator, and inotropic agent. She complained of dyspnea, and chest auscultation revealed pericardial friction rubs on day 28. Massive pericardial effusion was detected by echocardiography and pericarditis was diagnosed. The pericardial space was drained by pericardiocentesis. The pericardial fluid was exudative, but no bacteria or fungi were cultured. On viral polymerase chain reaction examination, human herpesvirus-6 was detected at a level of 3 × 10 4 copies/mL in the pericardial effusion, but not in the peripheral blood. With conservative treatment alone, that did not include antiviral therapy, her symptoms disappeared on day 56. We conclude that human herpesvirus-6 reactivation may have been associated with her pericarditis.

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“…Neier et al 7 suggested that PE is a significant risk factor for posttransplant mortality. We evaluated the effect of PE and other factors on 5-year OS and 5-year TRM using univariate and multivariate analysis.…”

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confidence: 99%

“…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.…”

mentioning

confidence: 99%

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

Chen

Zou

Yin

et al. 2015

Bone Marrow Transplant

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Pericardial effusion post-SCT in pediatric recipients with signs and/or symptoms of cardiac disease

Cited by 32 publications

References 24 publications

Pretransplant-corrected QT dispersion as a predictor of pericardial effusion after pediatric hematopoietic stem cell transplantation

Pretransplant-corrected QT dispersion as a predictor of pericardial effusion after pediatric hematopoietic stem cell transplantation

Untitled

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

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