title: Pericardial effusion post-SCT in pediatric recipients with signs and/or symptoms of cardiac disease.
abstract: The objective of this study was to assess the incidence, risk factors, outcome and impact on OS of pericardial effusion (PEF) in a cohort of 156 pediatric SCT recipients. The mean age was 8.15±6.25 years. In all, 74% of the patients had malignant disease and 35% of the patients received autologous stem cell grafts. Twenty-three subjects developed effusion at 2.75±3.54 months after SCT. The overall probability of developing a PEF after SCT was 16.9%. In the multivariate analysis of risk factors associated with time to PEF, increased age, allogeneic risk status and conditioning type, were all significant factors. In a multivariate analysis of time to death, PEF, CMV status and risk status were all independent risk factors. PEF, however, had the highest HR of 3.334. Of the 23 patients with PEF, 19 died (82.6%); however, none died as a direct result of pericardial tamponade. In summary, our results suggest that PEF is a significant risk factor for post transplant mortality. These results suggest a need for more frequent evaluation and monitoring for development of PEF. Studies are needed to determine the etiology of, and new therapeutic strategies for, PEF in the post-SCT population.
authors.affiliation: Department of Pediatrics, Medicine and Pathology, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University, New York, NY 10032, USA.
authors.forename: M
authors.initials: M
authors.lastname: Neier
authors.forename: Z
authors.initials: Z
authors.lastname: Jin
authors.forename: C
authors.initials: C
authors.lastname: Kleinman
authors.forename: L
authors.initials: L
authors.lastname: Baldinger
authors.forename: M
authors.initials: M
authors.lastname: Bhatia
authors.forename: E
authors.initials: E
authors.lastname: Silver
authors.forename: C
authors.initials: C
authors.lastname: van de Ven
authors.forename: E
authors.initials: E
authors.lastname: Morris
authors.forename: P
authors.initials: P
authors.lastname: Satwani
authors.forename: D
authors.initials: D
authors.lastname: George
authors.forename: J
authors.initials: J
authors.lastname: Garvin
authors.forename: M B
authors.initials: MB
authors.lastname: Bradley
authors.forename: J
authors.initials: J
authors.lastname: Schwartz
authors.forename: M S
authors.initials: MS
authors.lastname: Cairo
mesh_terms: D002648:Child; D002675:Child, Preschool; D006331:Heart Diseases / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D010490:Pericardial Effusion / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000401:mortality; D016896:Treatment Outcome