Infusion-related febrile reaction after haploidentical stem cell transplantation in children is associated with higher rates of engraftment syndrome and acute graft-versus-host disease.
The clinical significance and prognostic impact of IRFR in pediatric recipients of haploidentical SCT are not clearly understood. Therefore, we attempted to determine how IRFR affects clinical outcomes in children. Clinical data from 100 consecutive pediatric patients (60 boys and 40 girls; median age, 12 yr [range, 2-18 yr] after haploidentical SCT between January 2010 and December 2012 were collected retrospectively. IRFR was described as unexplained fever (>38 °C) within 24 h after the infusion of haploidentical PBSCs. Thirty-eight (38.0%) cases met the criteria for IRFR. ES was found in 24 (63.2%) of the 38 children with IRFR, with the median time of developing ES of +9 (7-16) days, while only 15 (25.4%) of the 59 children without IRFR were found with ES (p < 0.001). Similarly, the cumulative incidence rates of grade II-IV aGVHD were 50.0% in the IRFR group and 29.3% (p = 0.012) in the non-febrile group. Multivariate analysis identified IRFR as the risk factor for ES and aGVHD. In the haploidentical setting, IRFR is associated with the development of ES and aGVHD. We attempted to determine how IRFR affects clinical outcomes in children after haploidentical SCT. Thirty-eight children comprised the IRFR group, and 59 were in the control (non-IRFR) group. High incidence of ES was observed in children with the occurrence of IRFR. Similarly, the incidence of stage I-IV and II-IV aGVHD was significantly higher in the febrile group. Multivariate analysis showed IRFR to be the risk factor for ES and aGVHD.
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Yao
Y
Chen
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Xiao-Jun
XJ
Huang
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Kai-Yan
KY
Liu
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Huan
H
Chen
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Yu-Hong
YH
Chen
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Xiao-Hui
XH
Zhang
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Feng-Rong
FR
Wang
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Wei
W
Han
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Jing-Zhi
JZ
Wang
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Yu
Y
Wang
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Chen-Hua
CH
Yan
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Yuan-Yuan
YY
Zhang
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Yu-Qian
YQ
Sun
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
Lan-Ping
LP
Xu
D000208:Acute Disease; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology*; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D007263:Infusions, Parenteral; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013577:Syndrome
engraftment syndrome; graft-versus-host disease; haploidentical stem cell transplantation; infusion-related febrile reaction; pediatric