4
Average: 4 (2 votes)
Article

Engraftment Syndrome in Hematopoietic Stem Cell Transplantations

Kelli Thoele
CJON 2014, 18(3), 349-354 DOI: 10.1188/14.CJON.349-354

Hematopoietic stem cell transplantation (HSCT) is an increasingly common treatment option for malignant and nonmalignant diseases, but it has significant associated morbidity and mortality. Nurses caring for HSCT recipients must be aware of all potential complications, including engraftment syndrome (ES). Previous nursing literature has included little information on this syndrome, which often presents with noninfectious fever, skin rash, and pulmonary infiltrates, and ES may be fatal if left unidentified and treatment is not initiated promptly. Reports of the risk factors, incidence, clinical manifestations, diagnosis, treatment, and outcomes have much variation, likely from a lack of definite diagnostic criteria and inconsistency in the terminology associated with ES. The purpose of this article is to provide an overview of ES and the implications for nursing practice and research.

References 

Afessa, B., & Azoulay, E. (2010). Critical care of the hematopoietic stem cell transplant recipient. <i>Critical Care Clinics, 26</i>, 133-150. doi:10.1016/j.ccc.2009.09.001

Cahill, R.A., Spitzer, T.R., & Mazumder, A. (1996). Marrow engraftment and clinical manifestations of capillary lead syndrome. <i>Bone Marrow Transplantation, 18</i>, 177-184.

Capizzi, S.A., Kumar, S., Huneke, N.E., Gertz, M.A., Inwards, D.J., Litzow, M.R., … Tefferi, A. (2001). Peri-engraftment respiratory distress syndrome during autologous hematopoietic stem cell transplantation. <i>Bone Marrow Transplantation, 27</i>, 1299-1303.

Carreras, E., & Diaz-Ricart, M. (2011). The role of the endothelium in the short-term complications of hematopoietic SCT. <i>Bone Marrow Transplantation, 46</i>, 1495-1502. doi:10.1038/bmt.2011.65

Carreras, E., Fernández-Avilés, F., Silva, L., Guerrero, M., Fernández de Larrea, C., Martínez, C., … Rovira, M. (2010). Engraftment syndrome after auto-SCT: Analysis of diagnostic criteria and risk factors in a large series from a single center. <i>Bone Marrow Transplantation, 45</i>, 1417-1422. doi:10.1038/bmt.2009.363

Dispenzieri, A., Lacy, M.Q., Hayman, S.R., Kumar, S.K., Buadi, F., Dingli, D., … Gertz, M.A. (2008). Peripheral blood stem cell transplant for POEMS syndrome is associated with high rates of engraftment syndrome. <i>European Journal of Haematology, 80</i>, 397-406. doi:10.1111/j.1600-0609.2008.01037.x

Gabay, C., & Kushner, I. (1999). Acute-phase proteins and other systemic responses to inflammation. <i>New England Journal of Medicine, 340</i>, 448-454. doi:10.1056/NEJM199902113400607

González-Vicent, M., Ramírez, M. Sevilla, J., Pérez, A., Fernández, S., Madero, L., & Díaz, M.A. (2004). Engraftment syndrome after autologous peripheral blood progenitor cell transplantation in pediatric patients: A prospective evaluation of risk factors and outcome. <i>Bone Marrow Transplantation, 34</i>, 1051-1055. doi:10.1038/sj.bmt.1704698

Gorak, E., Geller, N., Srinivasan, R., Espinoza-Delgado, I., Donohue, T., Barrett, A.J., … Childs, R. (2005). Engraftment syndrome after nonmyeloablative allogeneic hematopoietic stem cell transplantation: Incidence and effects on survival. <i>Biology of Blood and Marrow Transplantation, 11</i>, 542-550. doi:10.1016/j.bbmt.2005.04.009

Gratwohl, A., Baldomero, H., Aljurf, M., Pasquini, M.C., Bouzas, L.F., Yoshimi, A., … Kodera, Y. (2010). Hematopoietic stem cell transplantation: A global perspective. <i>JAMA, 303</i>, 1617-1624.

Hong, K.T., Kang, H.J., Kim, N.H., Kim, M.S., Lee, J.W., Kim, H., … Ahn, H.S. (2013). Peri-engraftment syndrome in allogeneic hematopoietic SCT. <i>Bone Marrow Transplantation, 48</i>, 523-528.

Kanda, J., Kaynar, L., Kanda, Y., Prasad, V.K., Parikh, S.H., Lan, L., … Horwitz, M.E. (2013). Pre-engraftment syndrome after myeloablative dual umbilical cord blood transplantation: Risk factors and response to treatment. <i>Bone Marrow Transplantation, 48</i>, 926-931.

Koreth, J., Biernacki, M., Aldridge, J., Kim, H.T., Alyea, E.P., III, Armand, P., … Soiffer, R.J. (2011). Syngeneic donor hematopoietic stem cell transplantation is associated with high rates of engraftment syndrome. <i>Biology of Blood and Marrow Transplantation, 17</i>, 421-428. doi:10.1038/bmt.2012.279

Kushner, I. (2013). <i>Acute phase reactants.</i> Retrieved from http://www.uptodate.com/contents/acute-phase-reactants <a target="_blank" href='http://www.uptodate.com/contents/acute-phase-reactants'>http://www.uptod...

Lee, Y.H., Lim, Y.J., Kim, J.Y., Kim, Y.D., & Lee, S.W. (2008). Pre-engraftment syndrome in hematopoietic stem cell transplantation. <i>Journal of Korean Medical Science, 23</i>, 98-103.

Lopes da Silva, R., Costa, F., Ferreira, G., & de Sousa, A.B. (2012). Post-autologous hematopoietic SCT engraftment syndrome: A single center experience. <i>Bone Marrow Transplantation, 47</i>, 456-457. doi:10.1038/bmt.2011.92

Maiolino, A., Biasoli, I., Lima, J., Portugal, A.C., Pulcheri, W. & Nucci, M. (2003). Engraftment syndrome following autologous hematopoietic stem cell transplantation: Definition of diagnostic criteria. <i>Bone Marrow Transplantation, 31</i>, 393-397.

Moreb, J.S., Kubilis, P.S., Mullins, D.L., Myer, L., Youngblood, M., & Hutcheson, C. (1997). Increased frequency of autoaggression syndrome associated with autologous stem cell transplantation in breast cancer patients. <i>Bone Marrow Transplantation, 19</i>, 101-106. doi:10.1038/sj.bmt.1700615

Mossad, S., Kalaycio, M., Sobecks, R., Pohlman, B., Andresen, S., Avery, R., … Bolwell, B. (2005). Steroids prevent engraftment syndrome after autologous hematopoietic stem cell transplantation without increasing the risk of infection. <i>Bone Marrow Transplantation, 35</i>, 375-381. doi:10.1038/sj.bmt.1704769

Naeem, N., Eyzaguirre, A., Kern, J.A., Lazarus, H.M., Hejal, R.B., Laughlin, M.J., & Kern, E.F. (2006). Outcome of adult umbilical cord blood transplant patients admitted to a medical intensive care unit. <i>Bone Marrow Transplantation, 38</i>, 733-738.

Palomo, M., Diaz-Ricart, M., Carbo, C., Rovira, M., Fernandez-Aviles, F., Escolar, G., … Carreras, E. (2009). The release of soluble factors contributing to endothelial activation and damage after hematopoietic stem cell transplantation is not limited to the allogeneic setting and involves several pathogenic mechanisms. <i>Biology of Blood and Marrow Transplantation, 15</i>, 537-546.

Pasquini, M.C., & Wang, Z. (2011). Current use and outcome of hematopoietic stem cell transplantation: CIBMTR summary slides, 2011. Retrieved from <a target="_blank" href='http://www.cibmtr.org/ReferenceCenter/SlidesReports/SummarySlides/Pages/...

Patel, K.J., Rice, R.D., Hawke, R., Abboud, M., Heller, G., Scaradavou, A., … Barker, J.N. (2010). Pre-engraftment syndrome after double-unit cord blood transplantation: A distinct syndrome not associated with acute graft-versus-host disease. <i>Biology of Blood and Marrow Transplantation, 16</i>, 435-440.

Rimkus, C. (2009). Acute complications of stem cell transplant. <i>Seminars in Oncology Nursing, 25</i>, 129-138.

Schmid, I., Stachel, D., Pagel, P., & Albert, M.H. (2008). Incidence, predisposing factors, and outcome of engraftment syndrome in pediatric allogeneic stem cell transplant recipients. <i>Biology of Blood and Marrow Transplantation, 14</i>, 438-444.

Scott, P.H., Morgan, T.J., Durrant, S., & Boots, R.J. (2002). Survival following mechanical ventilation of recipients of bone marrow transplants and peripheral blood stem cell transplants. <i>Anaesthesia and Intensive Care, 30</i>, 289-294.

Spitzer, T.R. (2001). Engraftment syndrome following hematopoietic stem cell transplantation. <i>Bone Marrow Transplantation, 27</i>, 893-898. doi:10.1038/sj.bmt.1703015

Varani, J., & Ward, P.A. (1994). Mechanisms of endothelial cell injury in acute inflammation. <i>Shock, 2</i>, 311-319.