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• W1994846886 abstract "Background: Pericardial effusion (PCE) has only sporadically been reported in transplant recipients. We studied a large series of pediatric patients undergoing unrelated umbilical cord blood transplantation (UCBT) at a single center to investigate PCE comprehensively.Methods: Between 01/2000 and 05/2008, 423 consecutive patients (median age 4.3 years; range 0.1–20.2 years) undergoing UCBT from a single cord blood unit (CBU) after myeloablative conditioning regimen were studied (median follow-up 1.8 years; range, 0.5–8.7 years). By low resolution HLA-A and –B and high resolution –DRB1 matching the CBU were 4/6 (53.8%), 5/6 (35.3%), or 6/6 (8.5%) matched. The patients (63% male; 33% CMV seropositive) had malignant (53.2%; n = 225; leukemia, lymphoma, MDS, others) and non-malignant (46.8%; n = 198; metabolic, immunodeficiency, marrow failure; and hemoglobinopathies) diagnoses. Cytoreduction contained TBI for 38.3% and cyclophosphamide for 69.5% patients. The graft-vs.-host disease (GVHD) prophylaxis was cyclosporine+cellcept in 25.8% (n = 109) and cyclosporine+methylprednisone in 73% (n = 309) patients.Results: A total of 108 (26%) patients developed at least one episode of PCE a median of 96 days (range, 9 – 2730 days) after transplant. PCE severity was moderate to very large in 56 and very small to moderate in 52 patients. Cardiac tamponade was seen in 28 (6.7%); pericardiocentesis was performed in 31 (7.3%); and 10 (2.4%) patients required pericardial window. Pericardial fluid did not reveal infection by cytology, cultures, PCR, or other tests. Cumulative incidence of PCE in patients with grades II-IV acute GVHD was 35% compared to 22% in those with either grade I or no evidence of acute GVHD. TBI, patient CMV serostatus, HLA match, chronic GVHD, age or sex of the patient had no impact on the incidence of PCE. PCE with tamponade was significantly higher (p = 0.02) and pericardiocentesis was needed more often (p = 0.03) in the patients on cellcept prophylaxis. The 1-yr post-UCBT survival in patients developing PCE was 55% compared to 63% in those without PCE. Twenty-eight (6.7%) patients with PCE had concomitant pleural and/or peritoneal fluid collection consistent with a “polyserositis syndrome”.Conclusion: Pericardial effusion occurs in a quarter of UCBT recipients but only a few are clinically important. Large PCE requiring drainage are more common with cellcept prophylaxis and should be considered if there are post-transplant cardiorespiratory problems. Background: Pericardial effusion (PCE) has only sporadically been reported in transplant recipients. We studied a large series of pediatric patients undergoing unrelated umbilical cord blood transplantation (UCBT) at a single center to investigate PCE comprehensively. Methods: Between 01/2000 and 05/2008, 423 consecutive patients (median age 4.3 years; range 0.1–20.2 years) undergoing UCBT from a single cord blood unit (CBU) after myeloablative conditioning regimen were studied (median follow-up 1.8 years; range, 0.5–8.7 years). By low resolution HLA-A and –B and high resolution –DRB1 matching the CBU were 4/6 (53.8%), 5/6 (35.3%), or 6/6 (8.5%) matched. The patients (63% male; 33% CMV seropositive) had malignant (53.2%; n = 225; leukemia, lymphoma, MDS, others) and non-malignant (46.8%; n = 198; metabolic, immunodeficiency, marrow failure; and hemoglobinopathies) diagnoses. Cytoreduction contained TBI for 38.3% and cyclophosphamide for 69.5% patients. The graft-vs.-host disease (GVHD) prophylaxis was cyclosporine+cellcept in 25.8% (n = 109) and cyclosporine+methylprednisone in 73% (n = 309) patients. Results: A total of 108 (26%) patients developed at least one episode of PCE a median of 96 days (range, 9 – 2730 days) after transplant. PCE severity was moderate to very large in 56 and very small to moderate in 52 patients. Cardiac tamponade was seen in 28 (6.7%); pericardiocentesis was performed in 31 (7.3%); and 10 (2.4%) patients required pericardial window. Pericardial fluid did not reveal infection by cytology, cultures, PCR, or other tests. Cumulative incidence of PCE in patients with grades II-IV acute GVHD was 35% compared to 22% in those with either grade I or no evidence of acute GVHD. TBI, patient CMV serostatus, HLA match, chronic GVHD, age or sex of the patient had no impact on the incidence of PCE. PCE with tamponade was significantly higher (p = 0.02) and pericardiocentesis was needed more often (p = 0.03) in the patients on cellcept prophylaxis. The 1-yr post-UCBT survival in patients developing PCE was 55% compared to 63% in those without PCE. Twenty-eight (6.7%) patients with PCE had concomitant pleural and/or peritoneal fluid collection consistent with a “polyserositis syndrome”. Conclusion: Pericardial effusion occurs in a quarter of UCBT recipients but only a few are clinically important. Large PCE requiring drainage are more common with cellcept prophylaxis and should be considered if there are post-transplant cardiorespiratory problems." @default.
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• W1994846886 title "Pericardial Effusion Following Unrelated Umbilical Cord Blood Transplantation: Analysis in a Cohort Of 423 Pediatric Patients Transplanted at a Single Center" @default.
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