Engraftment syndrome after allogeneic hematopoietic cell transplantation in adults

Aazim K. Omer, Haesook T. Kim, Bhargavi Yalamarti, Steven L. Mcafee, Bimalangshu R. Dey, Karen K. Ballen, Eyal Attar, Yi Bin Chen, Thomas R. Spitzer

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19 Scopus citations


We performed a retrospective study of the engraftment syndrome (ES) as defined by the Spitzer Criteria in adult patients undergoing allogeneic hematopoietic cell transplantation (HCT) for various hematological malignancies at a single institution, over a decade, and analyzed its relationship to acute GVHD; 217 patients underwent either myeloablative (38.7%) or reduced intensity (61.3%) HCT; 22.1% met the criteria for ES. Acute GVHD prophylaxis (P=0.006) and transplants prior to 2006 (P<0.0001) were significantly associated with a risk of ES in univariable analysis. Early aGVHD within 4 weeks of engraftment was significantly more common in the ES compared to the non ES cohort (21 vs. 8.3% respectively, P=0.02). ES did not predict for future GVHD, as at day +180, the cumulative incidences of grades II-IV aGVHD (31 vs. 23%, P=0.19) and of chronic GVHD at 2 years of engraftment (42 vs. 36%, P=0.28) were not significantly different between the ES and non ES groups, respectively. No significant differences in NRM, overall survival and progression-free survival were observed between the two groups. Although predictive of early aGVHD, ES occurred independently of GVHD in 79% of the patients. Survival outcomes should be evaluated in a larger randomized study to investigate if there is a correlation with ES. Am. J. Hematol. 89:698-705, 2014.

Original languageEnglish (US)
Pages (from-to)698-705
Number of pages8
JournalAmerican Journal of Hematology
Issue number7
StatePublished - Jul 2014


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