Incidence and Outcome of Pericardial Effusion in Pediatric Patients after Hematopoietic Stem Cell Transplant: A Single-institution Experience

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Abstract

Background: Pericardial effusion (PE) is a known complication after hematopoietic stem cell transplant (HSCT). Limited data is currently available regarding the incidence and outcomes of PE in pediatric HSCT. Methods: We conducted a retrospective study on a cohort of patients who underwent HSCT between 2004 and 2015. Risk factors associated with development of PE were evaluated. Results: In 111 HSCT, stem cell source was bone marrow in 37 (33.3%), peripheral blood - 42 (37.8%) and cord blood - 32 (28.8%). Incidence of PE after HSCT was 37.8%. Insignificant effusion (trivial or small) was noted in 30 (27.0%) transplants, and significant (moderate or large) PE in 12 (10.8%). There were no associations between incidence of effusion and stem cell source, graft versus host disease or CMV infection. Risk factors associated with development of PE included systemic hypertension (P<0.05), total body irradiation (P<0.05), and sinusoidal obstruction syndrome formerly known as venoocclusive disease (P=0.03). Overall mortality was 22.5% after HSCT, but 38.1% among those with effusion (P<0.05). None of these deaths were attributed to primary cardiac etiologies. Conclusions: The incidence of PE in this cohort of pediatric HSCT recipients is high and associated with higher morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)132-136
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
Volume40
Issue number2
DOIs
StatePublished - Jan 1 2018

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Pericardial Effusion
Hematopoietic Stem Cells
Pediatrics
Transplants
Incidence
Stem Cells
Hepatic Veno-Occlusive Disease
Mortality
Whole-Body Irradiation
Graft vs Host Disease
Fetal Blood
Retrospective Studies
Bone Marrow
Hypertension
Morbidity
Infection

Keywords

  • hematopoietic stem cell transplantation
  • pediatric bone marrow transplant
  • pericardial effusion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

@article{f198c40cd7f645ad9c404110419266bb,
title = "Incidence and Outcome of Pericardial Effusion in Pediatric Patients after Hematopoietic Stem Cell Transplant: A Single-institution Experience",
abstract = "Background: Pericardial effusion (PE) is a known complication after hematopoietic stem cell transplant (HSCT). Limited data is currently available regarding the incidence and outcomes of PE in pediatric HSCT. Methods: We conducted a retrospective study on a cohort of patients who underwent HSCT between 2004 and 2015. Risk factors associated with development of PE were evaluated. Results: In 111 HSCT, stem cell source was bone marrow in 37 (33.3{\%}), peripheral blood - 42 (37.8{\%}) and cord blood - 32 (28.8{\%}). Incidence of PE after HSCT was 37.8{\%}. Insignificant effusion (trivial or small) was noted in 30 (27.0{\%}) transplants, and significant (moderate or large) PE in 12 (10.8{\%}). There were no associations between incidence of effusion and stem cell source, graft versus host disease or CMV infection. Risk factors associated with development of PE included systemic hypertension (P<0.05), total body irradiation (P<0.05), and sinusoidal obstruction syndrome formerly known as venoocclusive disease (P=0.03). Overall mortality was 22.5{\%} after HSCT, but 38.1{\%} among those with effusion (P<0.05). None of these deaths were attributed to primary cardiac etiologies. Conclusions: The incidence of PE in this cohort of pediatric HSCT recipients is high and associated with higher morbidity and mortality.",
keywords = "hematopoietic stem cell transplantation, pediatric bone marrow transplant, pericardial effusion",
author = "Melissa DIamond and Catalina Ruiz-Mesa and Fernando Corrales-Medina and Leonardo Tamariz and Edward Ziga and Sethuraman Swaminathan",
year = "2018",
month = "1",
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doi = "10.1097/MPH.0000000000000974",
language = "English (US)",
volume = "40",
pages = "132--136",
journal = "Journal of Pediatric Hematology/Oncology",
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publisher = "Lippincott Williams and Wilkins",
number = "2",

}

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T1 - Incidence and Outcome of Pericardial Effusion in Pediatric Patients after Hematopoietic Stem Cell Transplant

T2 - A Single-institution Experience

AU - DIamond, Melissa

AU - Ruiz-Mesa, Catalina

AU - Corrales-Medina, Fernando

AU - Tamariz, Leonardo

AU - Ziga, Edward

AU - Swaminathan, Sethuraman

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Pericardial effusion (PE) is a known complication after hematopoietic stem cell transplant (HSCT). Limited data is currently available regarding the incidence and outcomes of PE in pediatric HSCT. Methods: We conducted a retrospective study on a cohort of patients who underwent HSCT between 2004 and 2015. Risk factors associated with development of PE were evaluated. Results: In 111 HSCT, stem cell source was bone marrow in 37 (33.3%), peripheral blood - 42 (37.8%) and cord blood - 32 (28.8%). Incidence of PE after HSCT was 37.8%. Insignificant effusion (trivial or small) was noted in 30 (27.0%) transplants, and significant (moderate or large) PE in 12 (10.8%). There were no associations between incidence of effusion and stem cell source, graft versus host disease or CMV infection. Risk factors associated with development of PE included systemic hypertension (P<0.05), total body irradiation (P<0.05), and sinusoidal obstruction syndrome formerly known as venoocclusive disease (P=0.03). Overall mortality was 22.5% after HSCT, but 38.1% among those with effusion (P<0.05). None of these deaths were attributed to primary cardiac etiologies. Conclusions: The incidence of PE in this cohort of pediatric HSCT recipients is high and associated with higher morbidity and mortality.

AB - Background: Pericardial effusion (PE) is a known complication after hematopoietic stem cell transplant (HSCT). Limited data is currently available regarding the incidence and outcomes of PE in pediatric HSCT. Methods: We conducted a retrospective study on a cohort of patients who underwent HSCT between 2004 and 2015. Risk factors associated with development of PE were evaluated. Results: In 111 HSCT, stem cell source was bone marrow in 37 (33.3%), peripheral blood - 42 (37.8%) and cord blood - 32 (28.8%). Incidence of PE after HSCT was 37.8%. Insignificant effusion (trivial or small) was noted in 30 (27.0%) transplants, and significant (moderate or large) PE in 12 (10.8%). There were no associations between incidence of effusion and stem cell source, graft versus host disease or CMV infection. Risk factors associated with development of PE included systemic hypertension (P<0.05), total body irradiation (P<0.05), and sinusoidal obstruction syndrome formerly known as venoocclusive disease (P=0.03). Overall mortality was 22.5% after HSCT, but 38.1% among those with effusion (P<0.05). None of these deaths were attributed to primary cardiac etiologies. Conclusions: The incidence of PE in this cohort of pediatric HSCT recipients is high and associated with higher morbidity and mortality.

KW - hematopoietic stem cell transplantation

KW - pediatric bone marrow transplant

KW - pericardial effusion

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