title: Pericardial effusion after pediatric hematopoietic cell transplant.
abstract: PE can occur following HCT. However, the incidence, etiology, risk factors, and treatment remain unclear. We performed a retrospective study evaluating 355 pediatric recipients of HCT treated at a single institution between January 2005 and August 2010. No cases of PE were identified in the autologous HCT (auto-HCT) recipients (0/43), while 19% (57/296) of allogeneic HCT (allo-HCT) developed PE. Among the 57 PE patients, 40 (70%) were males; the median age at transplantation was 6.6 yr (0.1-17.3 yr). Thirty-six patients (63%) had significant PE with 23 patients (40%) treated by pericardiocentesis, and 19 (33%) experiencing recurrent PE. OS rates for patients who developed PE were 84% at 100 days and 65% at three yr after HCT. Risk factors associated with PE on multivariate analysis included myeloablative conditioning (p = 0.01), delayed neutrophil engraftment (p < 0.01), and CMV + serostatus of the recipient (p = 0.03). Recipients with non-malignant diseases were significantly less likely to die after development of PE (p = 0.02 and 0.004 when comparing with standard and high-risk diseases, respectively). In summary, PE is a common and significant complication of pediatric allo-HCT. Prospective studies are needed to better determine the etiology and optimal method of PE treatment after HCT.
authors: Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN 55454, USA. aldo0020@umn.edu
authors: Osamah
authors: O
authors: Aldoss
authors: Daniel H
authors: DH
authors: Gruenstein
authors: John L
authors: JL
authors: Bass
authors: Julia
authors: J
authors: Steinberger
authors: Yan
authors: Y
authors: Zhang
authors: Todd E
authors: TE
authors: Defor
authors: Jakub
authors: J
authors: Tolar
authors: Michael R
authors: MR
authors: Verneris
authors: Paul J
authors: PJ
authors: Orchard
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000150:complications; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D009504:Neutrophils / Q000166:cytology; D010490:Pericardial Effusion / Q000175:diagnosis*; D020519:Pericardiocentesis / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D013997:Time Factors; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome