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Acute Complications in Stem Cell Transplantation

  • Living reference work entry
  • First Online:
Contemporary Bone Marrow Transplantation

Part of the book series: Organ and Tissue Transplantation ((OTT))

Abstract

Hematopoietic stem cell transplantation (HSCT) remains an effective method for treating a multitude of malignant or nonmalignant disorders. While in autologous HSCT, patients receive their own stem cells after myeloablation, allogeneic HSCT implies using stem cells derived from a donor. It is often a last curative option, however, associated with a considerable risk of early and long-term complications. Acute complications determine the future course of illness, have a bearing on chronic complications, and overall quality of life. Similar to acute graft-versus-host disease, complications till day+100 posttransplant are included under acute complications. These include endothelial pathologies like engraftment syndrome (ES), transplant-associated thrombotic microangiopathy (TA-TMA), veno-occlusive disease of liver (VOD), capillary leak syndrome, and others which include noninfectious pulmonary complications, posterior reversible encephalopathy syndrome (PRES), infections (bacterial/fungal/viral), acute graft-versus-host disease (aGVHD), mucositis, and graft failure. It is important to recognize these complications at the earliest, for implementing suitable interventions, salvaging the graft and to prevent any disease relapse.

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Abbreviations

ADAMTS13:

A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13

ADCC:

Antibody-mediated cellular cytotoxicity

ADV:

Adenovirus

aGVHD:

Acute graft-versus-host disease

AML:

Acute myeloid leukemia

ARDS:

Acute respiratory distress syndrome

ASCT:

Autologous stem cell transplant

BAL:

Bronchoscopic alveolar lavage

BEAM:

BCNU (Carmustine), Etoposide, Ara-C (Cytarabine), Melphalan

BOS:

Bronchiolitis obliterans syndrome

CBT:

Cord blood transplant

CDC:

Complement-dependent cytotoxicity

CLS:

Capillary leak syndrome

CMV:

Cytomegalo virus

CNIs:

Calcineurin inhibitors

COP:

Cryptogenic organizing pneumonia

CSA:

Cyclosporine A

CY/TBI:

Cyclophosphamide/Total-body irradiation

DAH:

Diffuse alveolar hemorrhage

DFS:

Disease-free survival

DLI:

Donor lymphocyte infusion

DPTS:

Delayed pulmonary toxicity syndrome

ES:

Engraftment syndrome

FDA:

Food and Drug Administration

GCSF:

Granulocyte colony stimulating factor

HSCT:

Hematopoietic stem cell transplantation

HSV:

Herpes simplex virus

IPS:

Idiopathic pneumonia syndrome

IVIg:

Intravenous immunoglobulin

KGF:

Keratinocyte growth factor

LDH:

Lactate dehydrogenase

MAC:

Myelo-ablative conditioning

MASCC-ISOO:

Multinational association of supportive care in cancer and international society of oral oncology

MEL:

Melphalan

MM:

Multiple myeloma

MODS/MOF:

Multiorgan dysfunction/failure

MRI:

Magnetic resonance imaging

NCI CTCAEv5.0:

National Cancer Institute Common Terminology Criteria for Adverse Events

NMA:

Nonmyeloablative

NRM:

Nonrelapse mortality

OS:

Overall survival

PAI-1:

Plasminogen activator inhibitor – 1

PAP:

Pulmonary alveolar proteinosis

PCT:

Procalcitonin

PCT:

Pulmonary cytolytic thrombi

POEMS:

Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes

PRES:

Posterior reversible encephalopathy syndrome

PTLD:

Posttransplant lymphoproliferative disease

REG3α:

Regenerating islet-derived 2-alpha

RIC:

Reduced intensity conditioning

SOS:

Sinusoidal obstruction syndrome

SPI:

Solid-phase immunoassays

ST-2:

Suppressor of tumorigenicity-2

TA-TMA:

Transplant-associated thrombotic micro-angiopathy

TBI:

Total body irradiation

TIPS:

Transjugular intrahepatic portosystemic shunt

TNF:

Tumor necrosis factor

TPE:

Therapeutic plasma exchange

TPN:

Total parenteral nutrition

TPO-RAs:

Thrombopoietin receptor agonists

TRALI:

Transfusion-associated acute lung injury

VOD:

Veno-occlusive disease of liver

vWF:

von-Willebrand factor

WHO:

World Health Organization

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Authors and Affiliations

  1. Adult Hematolymphoid & BMT, Tata Memorial Hospital ACTREC, Mumbai, Maharashtra, India

    Sumeet Mirgh

  2. Department of Medical Oncology and Bone Marrow Transplantation, Tata Memorial Hospital, Mumbai, Maharashtra, India

    Navin Khattry

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  1. Sumeet Mirgh
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  2. Navin Khattry
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Editors and Affiliations

  1. Tata Medical Center, Kolkata, West Bengal, India

    Mammen Chandy

  2. CLINICAL HAEMATOLOGY and HCT, Tata Medical Center, Kolkata, West Bengal, India

    Vivek S Radhakrishnan

  3. Oncology Centre of Excellence, Tata Medical Center, Kolkata, West Bengal, India

    Reghu Sukumaran

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  1. Pediatric Hematology and Oncology, Tata Medical Center, Kolkata, India

    Reghu Sukumaran

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Mirgh, S., Khattry, N. (2020). Acute Complications in Stem Cell Transplantation. In: Chandy, M., Radhakrishnan, V.S., Sukumaran, R. (eds) Contemporary Bone Marrow Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-64938-2_6-1

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