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Pericardial effusion after pediatric hematopoietic cell transplant
Author(s) -
Aldoss Osamah,
Gruenstein Daniel H.,
Bass John L.,
Steinberger Julia,
Zhang Yan,
DeFor Todd E.,
Tolar Jakub,
Verneris Michael R.,
Orchard Paul J.
Publication year - 2013
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12062
Subject(s) - medicine , etiology , incidence (geometry) , transplantation , surgery , pericardiocentesis , gastroenterology , complication , multivariate analysis , cumulative incidence , hematopoietic stem cell transplantation , retrospective cohort study , prospective cohort study , pericardial effusion , physics , optics
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 .