Epidemiology, risk factors, and prognosis of capillary leak syndrome in pediatric recipients of stem cell transplants: a retrospective single‐center cohort study

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.