Pulmonary manifestations of the pre-engraftment syndrome after umbilical cord blood transplantation

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• 作者：Kyle R. Brownback (1)
  Steven Q. Simpson (1)
  Joseph P. McGuirk (2)
  Tara L. Lin (2)
  Sunil Abhyankar (2)
  Siddhartha Ganguly (2)
  Omar S. Aljitawi (2)
  
• 关键词：Immunocompromised ; Pre ; engraftment syndrome ; Respiratory failure ; Umbilical cord blood transplantation
• 刊名：Annals of Hematology
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：93
• 期：5
• 页码：847-854
• 全文大小：278 KB
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• 作者单位：Kyle R. Brownback (1)
  Steven Q. Simpson (1)
  Joseph P. McGuirk (2)
  Tara L. Lin (2)
  Sunil Abhyankar (2)
  Siddhartha Ganguly (2)
  Omar S. Aljitawi (2)
  
  1. Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
  2. Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, KS, USA
  
• ISSN：1432-0584

文摘

Pre-engraftment syndrome (PES) is a condition occurring after umbilical cord blood transplantation (UCBT) characterized by fever and erythematous skin rash prior to neutrophil engraftment. We sought to determine the incidence and characterize the pulmonary manifestations of PES. A retrospective review of patients who underwent UCBT at the University of Kansas Medical Center over a 5-year period was performed. Data collected included patient baseline characteristics, presence of PES, pulmonary findings, treatments, and survival. Forty-four patients underwent UCBT with 22 of those patients developing PES. Full-intensity myeloablative conditioning regimen was found to be a risk factor for development of PES. Of those 22 patients, 13 had resting hypoxemia. The most common radiographic findings included diffuse ground glass opacities with pleural effusions. Fifteen patients with PES received corticosteroids, of which 12 had improvement in fevers and rash. These patients had a trend toward worse mortality than those not receiving corticosteroids. There was a nonsignificant trend toward worse survival in patients with PES and hypoxemia compared to those without hypoxemia. PES is a common complication following cord blood transplantation, with hypoxemia being present in over half of patients with PES. Hypoxemia with PES and treatment with corticosteroids may portend a worse prognosis.