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Engraftment syndrome after allogeneic hematopoietic cell transplantation in adults
Author(s) -
Omer Aazim K.,
Kim Haesook T.,
Yalamarti Bhargavi,
McAfee Steven L.,
Dey Bimalangshu R.,
Ballen Karen K.,
Attar Eyal,
Chen YiBin,
Spitzer Thomas R.
Publication year - 2014
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23716
Subject(s) - medicine , hematopoietic stem cell transplantation , transplantation , hematopoietic cell , gastroenterology , cumulative incidence , cohort , retrospective cohort study , overall survival , hematology , haematopoiesis , oncology , immunology , stem cell , biology , genetics
We performed a retrospective study of the engraftment syndrome (ES) as defined by the Spitzer Criteria in adult patients undergoing allogeneic hematopoietic cell transplantation (HCT) for various hematological malignancies at a single institution, over a decade, and analyzed its relationship to acute GVHD; 217 patients underwent either myeloablative (38.7%) or reduced intensity (61.3%) HCT; 22.1% met the criteria for ES. Acute GVHD prophylaxis ( P = 0.006) and transplants prior to 2006 ( P < 0.0001) were significantly associated with a risk of ES in univariable analysis. Early aGVHD within 4 weeks of engraftment was significantly more common in the ES compared to the non ES cohort (21 vs. 8.3% respectively, P = 0.02). ES did not predict for future GVHD, as at day +180, the cumulative incidences of grades II–IV aGVHD (31 vs. 23%, P = 0.19) and of chronic GVHD at 2 years of engraftment (42 vs. 36%, P = 0.28) were not significantly different between the ES and non ES groups, respectively. No significant differences in NRM, overall survival and progression‐free survival were observed between the two groups. Although predictive of early aGVHD, ES occurred independently of GVHD in 79% of the patients. Survival outcomes should be evaluated in a larger randomized study to investigate if there is a correlation with ES. Am. J. Hematol. 89:698–705, 2014. © 2014 Wiley Periodicals, Inc.