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.

Abnormal Echocardiography 7 Days after Stem Cell Transplantation May Be an Early Indicator of Thrombotic Microangiopathy

“…PEF, if left untreated, can cause cardiac tamponade, acutely decreasing cardiac function [2–6]. The reported incidence of PEF in retrospective cohorts has varied from 0.2% to 19% in patients after HSCT [7,8]. In our institution, we found a high incidence of PEFs in patients with transplant-associated thrombotic microangiopathy (TA-TMA) [9].…”

Pericardial effusion in pediatric SCT recipients with thrombotic microangiopathy

“…1,2 The exact incidence and risk factors are not well described, but retrospective reviews report PEF occurring in 0.2-19% of HSCT patients. 1,3,4 Age, gender, preparative conditioning regimen, GVHD and CMV or EBV viremias have been suggested as potential risk factors. 1 The initial symptoms of PEF can be nonspecific, thus early detection and identification may improve patient outcomes.…”

“…1,3,4 Age, gender, preparative conditioning regimen, GVHD and CMV or EBV viremias have been suggested as potential risk factors. 1 The initial symptoms of PEF can be nonspecific, thus early detection and identification may improve patient outcomes.…”

Pericardial effusion post transplantation predicts inferior overall survival following allo-hematopoietic stem cell transplant

“…Pericardial effusion (PE) is a known complication of HSCT that can result in significant morbidity and even death by causing acute cardiac tamponade. 1,2 The exact incidence and risk factors are not well established, but retrospective reviews report PE occurring in 0.2-19% of HSCT patients. 1,3,4 Age, gender, disease risk, conditioning regimen, neutrophil engraftment, relapse, GVHD, GVHD prophylaxis, donor type and CMV viremias have been suggested as potential risk factors.…”

“…1,3,4 Age, gender, disease risk, conditioning regimen, neutrophil engraftment, relapse, GVHD, GVHD prophylaxis, donor type and CMV viremias have been suggested as potential risk factors. 1,[4][5][6][7] The initial symptoms of PE can be non-specific, thus early recognition of PE may allow us to further optimize care and improve outcomes.…”