06 June 2024 : Original article
[In Press] Engraftment Syndrome in Autologous Hematopoietic Stem Cell Transplant Patients: Incidence, Associated Risk Factors, Features, and Outcomes
Sira Mongkolrat1ABCDEF, Adisak Tantiworawit 2ADE, Piangrawee Niprapan 2E, Pokpong Piriyakhuntorn 3BDE, Teerachat Punnachet 2E, Nonthakorn Hantrakun 2E, Thanawat Rattanathammethee 2E, Sasinee Hantrakool 2E, Chatree Chai-Adisaksopha 2E, Ekarat Rattarittamrong 2E, Lalita Norasetthada 2EDOI: 10.12659/AOT.944043
Ann Transplant In Press; DOI: 10.12659/AOT.944043
Available online: 2024-06-06, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Abstract
BACKGROUND
Autologous stem cell transplantation (ASCT) is the standard treatment for multiple myeloma (MM) and refractory/relapsed (R/R) lymphoma patients. Engraftment syndrome (ES) is a non-infectious febrile syndrome during ASCT. This study focused on the incidence, risk factors, manifestations, and outcomes of patients with ES receiving ASCT.
MATERIAL AND METHODS
This retrospective cohort study included MM and R/R lymphoma patients who underwent ASCT at Chiang Mai University Hospital from January 2014 to September 2020. ES was diagnosed by the consensus of independent reviewers based on clinical manifestations, laboratory, and radiological findings.
RESULTS
We included 124 patients, of whom 67 (54.1%) had lymphoma. The mean age was 48.0±12.3 years. The incidence of ES was 36.3%. The ES group had a significantly higher proportion of patients with fever, elevated liver enzymes, elevated bilirubin, hypoalbuminemia, and weight gain compared to the non-ES group. TNC more than 10×10⁸ cells/kg was an independent risk factor for ES (odds ratio 2.94 with a 95% confidence interval of 1.15-7.50, P=0.024). ES was associated with longer length of stay (22.5±8.2 vs 16.9±6.4 days, P<0.001) but was not associated with overall survival (OS).
CONCLUSIONS
The incidence of ES in this cohort was 36.3%. Features observed in ES patients were fever, elevated liver enzymes, elevated bilirubin, and hypoalbuminemia. TNC of more than 10×10⁸ cells/kg was an independent risk factor. ES was associated with longer length of stay but not survival outcomes.
Keywords: Bone Marrow Transplantation; Incidence; Multiple Myeloma; Risk Factors
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