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. 2018 Jul;34(3):448-453.
doi: 10.1007/s12288-017-0899-4. Epub 2017 Nov 15.

Engraftment Syndrome: Clinical Features and Predictive Factors in Autologous Stem Cell Transplant

V Sheth  1 , R Jain  1   2 , A Gore  1 , A Ghanekar  1 , T Saikia  1
Affiliations

Engraftment Syndrome: Clinical Features and Predictive Factors in Autologous Stem Cell Transplant

V Sheth et al. Indian J Hematol Blood Transfus. 2018 Jul.

Abstract

Engraftment Syndrome (ES) maybe observed in patients who undergo autologous stem cell transplant (SCT). To investigate clinical criteria for ES diagnosis and analyse the risk factors for this complication, we reviewed all auto-SCT cases (Lymphoma and Myeloma) performed during the past 9 years at two tertiary care centres. We analysed all patients with a non-infectious fever, developed within 7 days of engraftment (first day of ANC of 500 on two consecutive days) in 178 patients undergoing autologous stem cell transplant. A total of 46/178 (25.8%) patients developed non-infectious fever and one or more clinical signs of ES within 7 days of engraftment. In all, 29 (61%) fulfilled the Maiolino and 12 (26%) the Spitzer criteria. The incidence of engraftment syndrome using the Maiolino criteria in our study was 29 (15%), which compares well with Spanish study (13% using same criteria) and the original Maiolino study (20%). All patients with ES satisfactorily recovered and discharged with a median of 20 days from hospital. There was no significant difference in number of days of hospitalisation and days of antibiotics between the ES and non ES arms. All patients recovered without any morbidity and only 1 (2%) patient required readmission for fungal pneumonitis. 8 (17%) patients required ICU admission due to delay in initiation of steroids. None of the factors including number of chemotherapy cycles, conditioning regime, disease status, CD34 collection, growth factors and day of WBC engraftment except female (p = 0.064) were statistically significant (in univariate or multivariate analysis). Our study shows that engraftment syndrome is common in autologous transplant setting. Maiolino criteria to diagnose ES is more sensitive in our setting. If detected and treated early there is not much morbidity or mortality related to ES.

Keywords: Autologous stem cell transplantation; Engraftment fever; Engraftment syndrome; Non-infectious fever.

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Conflict of interest statement

Compliance with Ethical StandardsNo conflict of interest or funding to be declared.All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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References

    1. Lee CK, Gingrich RD, Hohl RJ, et al. Engraftment syndrome in autologous bone marrow and peripheral stem cell transplantation. Bone Marrow Transplant. 1995;16:175–182. - PubMed
    1. Spitzer TR, et al. Engraftment syndrome following hematopoietic stem cell transplantation. Bone Marrow Transplant. 2001;27:893–898. doi: 10.1038/sj.bmt.1703015. - DOI - PubMed
    1. Rabinowitz J, Petros WP, Stuart AR, et al. Characterization of endogenous cytokine concentrations after high-dose chemotherapy with autologous bone marrow support. Blood. 1993;81(9):2452–2459. - PubMed
    1. Spitzer TR. Engraftment syndrome: double-edged sword of hematopoietic cell transplants. Bone Marrow Transplant. 2015;50:469–475. doi: 10.1038/bmt.2014.296. - DOI - PubMed
    1. Capizzi SA, Kumar S, Huneke NE, et al. Peri-engraftment respiratory distress syndrome during autologous hematopoietic stem cell transplantation. Bone Marrow Transplant. 2001;27:1299–1303. doi: 10.1038/sj.bmt.1703075. - DOI - PubMed

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