Favorable outcome to glucocorticoid therapy for engraftment syndrome in pediatric autologous hematopoietic cell transplant

Abongwa, Chenue; Abu‐Arja, Rolla; Rumelhart, S; Lazarus, Hillard M.; Abusin, Ghada

doi:10.1111/petr.12652

Cited by 6 publications

(13 citation statements)

References 14 publications

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“…However, there was no clear link between the starting dose and response to treatment as summarized in Table 1. Five articles 2,12,17‐19 used a starting dose of 1 mg/kg/d, three articles 11,13,16 used a starting dose of 2 mg/kg/d, and three articles 5,23,24 used a starting dose ranging 1‐2 mg/kg/d. Konuma et al 14 reported no treatment was used for ES.…”

Section: Resultsmentioning

confidence: 99%

“…Loose stools and gastrointestinal changes are not uncommon following HSCT and may be related to the conditioning regime, GVHD, or an infective cause. Stool cultures should be attained following the first incidence of diarrhea and accurate documentation of stool loss recorded 6,9,13,16,25 …”

Section: Discussionmentioning

confidence: 99%

“…This has led to a multitude of treatment regimens being used with no clear guidance on an effective approach. The most frequently documented treatment dose is 1‐2 mg/kg/d with no adverse events reported 2,6,9,11,13,16,22,23 …”

Section: Discussionmentioning

confidence: 99%

“…The major cytokines involved are thought to include interleukin‐1, interferon‐gamma, and tumor necrosis factor alpha 8,12‐15 . There is dramatic variation in the reported incidence of ES with the majority of authors identifying a range between 5% and 79% 13,14,16,17 …”

Section: Introductionmentioning

confidence: 99%

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Engraftment syndrome following hematopoietic stem cell transplant: A review of the literature

Grant

Chapman

Mitchell

et al. 2020

Clinical Transplantation

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Engraftment syndrome (ES) is a poorly understood condition which continues to present a significant cause of morbidity following haematopoietic stem cell transplantation (HSCT). Yet a standard approach to diagnosis and treatment of ES remains elusive and has the potential to impact patient outcomes. A literature search was performed using the databases ProQuest Health, PubMed, Medline and Embase. Included studies were published in English from 2001‐2019 that reported on engraftment syndrome following HSCT. Articles were organized by study design, ES diagnostic criteria, symptom classification and treatment. The review consolidated an array of literature relating to all types of HSCT. Timing of ES onset, risk factors and outcomes were compared within the literature. Signs and symptoms of reported ES were collated to establish a concise set of diagnostic criteria that can provide rapid recognition. The use of a standard approach to ES diagnosis has the potential to improve patient outcomes and provide a uniform approach to future research.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Engraftment syndrome following hematopoietic stem cell transplant: A review of the literature

Grant

Chapman

Mitchell

et al. 2020

Clinical Transplantation

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“…Steroids are thought to reduce the inflammatory response and the resultant capillary leak and often used in the setting of engraftment syndrome. A short course of steroids for 3–5 days was effective in children post-autologous transplant and did not increase the risk of infection ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Outcome of Acute Respiratory Failure Secondary to Engraftment in Children After Hematopoietic Stem Cell Transplant

et al. 2020

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Introduction: Respiratory complications due to engraftment syndrome (ES) in the post-hematopoietic stem cell transplant (HSCT) setting can lead to acute respiratory failure (ARF). Outcomes of children developing ARF due to engraftment are unknown. Methods: We conducted a retrospective analysis of 1,527 pediatric HSCT recipients and identified children who developed ARF due to ES over a 17-year period. Thirty patients that developed ARF and required invasive mechanical ventilation (IMV) due to ES were included in this study. Results: The survival rate for our cohort was 80% [alive at intensive care unit (ICU) discharge]. The most common underlying primary disease was hematologic malignancy, and 67% of children underwent allogeneic HSCT. Further, 73% required vasopressor drips and 23% underwent dialysis. Survivors had a shorter median ICU length of stay than did non-survivors (15 vs. 40 days, respectively, p = 0.01). Survivors had a significantly lower median cumulative fluid overload % on days 4 and 5 after initiation of IMV than did non-survivors (2.8 vs. 14.0 ml/kg, p = 0.038 on day 4, and 1.8 vs. 14.9 ml/kg, p = 0.044 on day 5, respectively). Conclusion: Our results suggest that children who develop ARF during engraftment have better ICU survival rates than do those with other etiologies of ARF post-HSCT. Furthermore, fluid overload contributes to mortality in these children; therefore, strategies to prevent and address fluid overload should be considered.

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Serum cytokine profiles during engraftment syndrome and acute graft-versus-host disease in adult patients after hematopoietic stem cell transplantation

Wu,

Jiang,

Jin

et al. 2024

Cytokine

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Favorable outcome to glucocorticoid therapy for engraftment syndrome in pediatric autologous hematopoietic cell transplant

Abstract: ES is a common complication in children after auto-HCT and short-course glucocorticoid therapy is an effective and well-tolerated treatment, even in those who did not completely fulfill diagnostic criteria.

Cited by 6 publications

References 14 publications

Engraftment syndrome following hematopoietic stem cell transplant: A review of the literature

Engraftment syndrome following hematopoietic stem cell transplant: A review of the literature

Outcome of Acute Respiratory Failure Secondary to Engraftment in Children After Hematopoietic Stem Cell Transplant

Serum cytokine profiles during engraftment syndrome and acute graft-versus-host disease in adult patients after hematopoietic stem cell transplantation

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