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Allografting

Peri-engraftment syndrome in allogeneic hematopoietic SCT

Bone Marrow Transplantation volume 48, pages 523–528 (2013)Cite this article

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Abstract

Engraftment syndrome (ES) and pre-engraftment syndrome (pre-ES) are both inflammatory conditions that occur after hematopoietic SCT (HSCT) and are characterized by non-infectious fever and skin rash. Although the pathogenesis is not fully understood, both syndromes are similar, and could be defined as a new clinical syndrome, named as peri-engraftment syndrome (peri-ES). We retrospectively analyzed the clinical records in 176 pediatric patients, following allogeneic HSCT. We utilized the definition of ES by Spitzer as the diagnostic criteria, excluding ‘within 96 h of engraftment’ criteria. Thirty cases developed peri-ES with a cumulative incidence of 17.0%. High cumulative incidence (50%) was seen in patients who underwent a double-unit cord blood transplantation (DUCBT; P<0.01). Clinical findings of peri-ES are similar, regardless of the onset day, and encephalopathy was the most severe complication. In the DUCBT cohort, the use of TBI and early complete chimerism (⩽day 21) were identified as risk factors that predispose the development of peri-ES. We determined that both, ES and pre-ES, might have similar causes, which could be included in peri-ES. Particularly, it occurred more in DUCBT patients, which means that not only neutrophil engraftment but also immune reactions within the two units might contribute to peri-ES.

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Acknowledgements

This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A102065) and by a grant (11172KFDA288) from Korea Food & Drug Administration in 2011.

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  1. Division of Hematology/Oncology, Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea

    K T Hong, H J Kang, N H Kim, M S Kim, J W Lee, H Kim, K D Park, H Y Shin & H S Ahn

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  1. K T Hong
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  2. H J Kang
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Correspondence to H J Kang.

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Hong, K., Kang, H., Kim, N. et al. Peri-engraftment syndrome in allogeneic hematopoietic SCT. Bone Marrow Transplant 48, 523–528 (2013). https://doi.org/10.1038/bmt.2012.171

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