Early Inflammatory Syndrome following Cord Blood Stem Cell Transplantation

Lee, Young Ho; Lee, Seung Won; Noh, Kyu Tae; Lee, Young Seok; Lee, Young Ah

Abstract

PURPOSE
We experienced the early toxicities in preengraftment period following cord blood stem cell transplantation (CBSCT), mimicking engraftment syndrome, characterized by fever, skin rash and fluid retention. We report these toxicities here, first in Korea, as an early inflammatory syndrome (EIS).
METHODS
We retrospectively reviewed the clinical data of 13 patients who received CBSCT with conventional conditioning chemotherapy for hematologic malignancies and immunodeficiency at Dong-A University Medical Center from 1998 to 2003. We defined the criteria for EIS as follows: noninfectious fever, skin rashes mimicking acute graft versus host disease and the evidence of fluid retention. These clinical signs should be appeared before neutrophil engraftment.
RESULTS
We experienced 3 cases of EIS in patients received the conventional dosage of conditioning chemotherapy for CBSCT, which developed on post-transplant day 7~10 and persisted for 2~7 days. Two out of 3 patients were recovered from EIS spontaneously or by supportive treatment, except 1 patient who expired due to complicated pulmonary hemorrhage.
CONCLUSION
The definition of EIS is yet obscure, thus more close observations for clinical course of CBSCT and pathophysiological research would be required.