23 July 2024 : Original article
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 2E
DOI: 10.12659/AOT.944043
Ann Transplant 2024; 29:e944043
Table 3 Risk factors of engraftment syndrome.
| Risk factors | ES (N=45) | Non-ES (N=79) | Univariable analysis | Multivariable analysis | ||||
|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | P value | OR | 95% CI | P value | |||
| Female, N (%) | 21 (46.7) | 34 (43.0) | 1.16 | 0.55–2.42 | 0.696 | – | – | – |
| Age >50 (%) | 30 (66.7) | 34 (43.0) | 2.65 | 1.23–5.68 | 0.012 | 2.17 | 0.79–5.96 | 0.134 |
| Diagnosis | ||||||||
| Lymphoma (%) | 16 (35.6) | 51 (64.6) | Ref | – | – | – | ||
| MM (%) | 29 (64.4) | 28 (35.4) | 3.30 | 1.54–7.09 | 0.002 | 2.12 | 0.83–5.41 | 0.114 |
| No. of regimens >1 (%) | 13 (28.9) | 25 (31.6) | 0.88 | 0.39–1.95 | 0.749 | – | – | – |
| Cyclophosphamide use (%) | 42 (93.3) | 71 (89.9) | 1.58 | 0.40–6.27 | 0.518 | – | – | – |
| Previous BMT (%) | 3 (6.7) | 4 (5.1) | 1.34 | 0.29–6.27 | 0.711 | – | – | – |
| Late stem cell harvest (%) | 32 (76.2) | 41 (54.7) | 2.65 | 1.14–6.17 | 0.023 | 1.42 | 0.46–4.39 | 0.548 |
| Mobilization | ||||||||
| Chemo-mobilization (%) | 16 (36.4) | 51 (68.0) | 0.27 | 0.12–0.59 | 0.001 | 0.41 | 0.07–2.42 | 0.322 |
| GCSF alone (%) | 28 (63.6) | 24 (32.0) | Ref | – | – | – | ||
| Plerixafor use (%) | 2 (4.5) | 12 (16.0) | 0.25 | 0.05–1.17 | 0.079 | 0.21 | 0.35–1.24 | 0.085 |
| Time to transplantation, months in median (IQR) | 8.9 (7.3–10.4) | 8.2 (6.2–11.2) | 1.02 | 0.95–1.10 | 0.554 | – | – | – |
| TNC dose ≥10×10 cells/kg, N (%) | 31 (47.7) | 13 (23.8) | 3.09 | 1.40–6.78 | 0.005 | 2.94* | 1.15–7.50 | |
| CD34 (×10 cells/kg), median (IQR) | 4.2 (2.9–6.0) | 4.6 (3.4–8.0) | 0.99 | 0.95–1.03 | 0.612 | – | – | – |
| Neutrophil engraftment, days in median (IQR) | 11 (10–12) | 10 (10–11) | 1.05 | 0.95–1.16 | 0.378 | – | – | – |
| Platelet engraftment, days in median (IQR) | 19 (16–24) | 18 (15–21) | 1.00 | 0.98–1.03 | 0.690 | – | – | – |
| Engraftment ALC, cells in median (IQR) | 160 (81–269) | 180 (80–325) | 1.00 | 1 | 0.126 | – | – | – |
| Amphotericin B use (%) | 17 (37.8) | 11 (13.9) | 3.75 | 1.56–9.02 | 0.003 | 4.33* | 1.57–11.94 | |
| * Adjusted for diagnosis. MM – multiple myeloma, TNC – total nucleated cell, ALC – absolute lymphocyte count. | ||||||||