Evaluation of engraftment syndrome in children following full-matched related donor hematopoietic stem cell transplantations.
The term "ES" has been widely used for describing a clinical condition consisting of skin rash, fever, and weight gain that occur during neutrophil recovery period following HSCT. In this study, the incidence, clinical features, risk factors, and outcomes of ES were evaluated in 169 children following allogeneic HSCT from full-matched related donor according to the Spitzer criteria. Seventeen patients (10.1%) presented with clinical conditions suggesting ES. In both univariate and multivariate analysis underlying malignant disease and early release of monocytes to the PB, and in univariate analysis using only CsA for GVHD prophylaxis were found to be the significant risk factors for the development of ES. Patients with ES experienced significantly higher incidence of acute and chronic GVHD and propensity toward a higher rate of TRM. OS did not differ between the patient groups. Thirteen of 17 patients received steroid therapy, and all but one patient responded to therapy. Monitoring for early detection of ES and early intervention with steroid therapy is the key for recovery. The most crucial approach for this purpose mainly is to find out and use the most useful and feasible diagnostic criteria for routine medical practice.
Department of Pediatric Hematology, Faculty of Medicine, Ankara University, Dikimevi, Ankara, Turkey.
Talia
T
İleri
Department of Pediatric Hematology, Faculty of Medicine, Ankara University, Dikimevi, Ankara, Turkey.
Elif
E
Ünal İnce
Department of Pediatric Hematology, Faculty of Medicine, Ankara University, Dikimevi, Ankara, Turkey.
Hasan
H
Çakmaklı
Department of Pediatric Hematology, Faculty of Medicine, Ankara University, Dikimevi, Ankara, Turkey.
Zümrüt
Z
Uysal
Department of Biostatistics, Faculty of Medicine, Ankara University, Dikimevi, Ankara, Turkey.
Zeynep
Z
Gençtürk
Department of Pediatric Hematology, Faculty of Medicine, Ankara University, Dikimevi, Ankara, Turkey.
Mehmet
M
Ertem
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005076:Exanthema / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006648:Histocompatibility; D006789:Host vs Graft Reaction / Q000276:immunology*; D006801:Humans; D015994:Incidence; D007223:Infant; D019520:Living Donors; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013577:Syndrome; D014184:Transplantation, Homologous; D015430:Weight Gain / Q000276:immunology*
allogeneic stem cell transplantation; children; engraftment syndrome; related donor