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Epidemiology, risk factors, and prognosis of capillary leak syndrome in pediatric recipients of stem cell transplants: a retrospective single‐center cohort study
Author(s) -
Lucchini Giovanna,
Willasch Andre Manfred,
Daniel Julia,
Soerensen Jan,
Jarisch Andrea,
Bakhtiar Shahrzad,
Rettinger Eva,
Brandt Joerg,
Klingebiel Thomas,
Bader Peter
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.12831
Subject(s) - medicine , cls upper limits , sepsis , single center , retrospective cohort study , incidence (geometry) , complication , cytokine release syndrome , transplantation , surgery , cohort , gastroenterology , disease , physics , covid-19 , optometry , infectious disease (medical specialty) , optics
Abstract CLS involves sudden loss of intravascular fluids into the interstitial spaces. CLS was described as a possible complication after SCT . Few studies report the incidence of CLS in pediatric populations. We aimed to assess CLS incidence, its risk factors, and impact on the survival. The clinical charts of patients <18 years of age transplanted at our institution between 2002 and 2012 were reviewed. CLS was defined by weight gain >3% in 24 hours and positive intake balance despite furosemide administration. In total, 234 patients underwent 275 allogeneic SCT procedures in the analyzed time frame. Fifteen patients developed CLS (5.4%). The probability of developing CLS was significantly increased in patients suffering from sepsis (14.3% vs 0.6%, P <.001). Patients with CLS exhibited an increased risk of acute Gv HD in the first 30 days after SCT (10.8% vs 1.8%, P =.002). Ten of the patients with CLS required intensive care. CLS strongly impacts OS at day +100 after SCT and is a predictive factor of TRM at the same date (42.9% vs 5%, P <.0001). The biological relation among sepsis, Gv HD , and CLS development in terms of cytokine release and endothelial damage warrants further studies.