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Favorable outcome to glucocorticoid therapy for engraftment syndrome in pediatric autologous hematopoietic cell transplant
Author(s) -
Abongwa Chenue,
AbuArja Rolla,
Rumelhart Stephen,
Lazarus Hillard M.,
Abusin Ghada
Publication year - 2016
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.12652
Subject(s) - medicine , glucocorticoid , rash , methylprednisolone , complication , diarrhea , hematopoietic stem cell transplantation , surgery , transplantation , leukopenia , retrospective cohort study , gastroenterology , toxicity
ES remains an important cause of morbidity and mortality in children undergoing auto‐ HCT . Glucocorticoid use in ES is an area of debate. We retrospectively analyzed single‐institution experience from September 2000 through December 2012 to evaluate the use of glucocorticoids in auto‐ HCT patients. ES was defined by the occurrence of new onset of non‐infectious fever plus diarrhea, rash, or pulmonary infiltrates 24‐h before or within five days after neutrophil engraftment. Sixty‐five pediatric patients (<21 yr) with different solid tumors underwent auto‐ HCT s in the study period. Fifteen patients (23%) fulfilled criteria for ES , of which 13 received methylprednisolone (2 mg/kg IV for 3–5 days). Clinical improvement occurred in all patients within 48 h without significant complications. In the non‐ ES group, 11 patients received glucocorticoid without significant complications as well. MEL‐based regimens were found to be significant factor for ES (p < 0.05). Fever, edema, non‐infectious diarrhea, and serum albumin concentration were statistically different between the two groups. Median hospital length of stay was higher in the ES group. Conclusion: 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.