Engraftment syndrome

Spitzer TR. Engraftment syndrome following hematopoietic stem cell transplantation. Bone Marrow Transplant 2001 27 893-898. 

PERDS refers to the pulmonary component of the engraftment syndrome. It occurs in about 5% of autologous BMT recipients and responds favorably to treatment (11). The pathogenesis of PERDS is not known. It is believed to be due to a complex interaction between conditioning-related endothelial damage and cytokine release associated with the neutrophil and lymphocyte recovery. 

High-dose corticosteroids usually lead to rapid clinical improvement in PERDS (11). A short course of corticosteroid therapy has been used effectively to prevent engraftment syndrome in autologous BMT recipients (18). Unlike DAH and IPS, only about one-third of BMT recipients with PERDS require ICU admission and mechanical ventilation. The reported case fatahty rate of PERDS is approximately 21% (11). 

Mossad S, Kalaycio M, Sobecks R, et al. Steroids prevent engraftment syndrome after autologous hematopoietic stem cell transplantation without increasing the risk of infection. Bone Marrow Transplant 2005 35(4) 375 81. 

During the period of neutropenia, patients have a significant risk of developing non-infectious pulmonary complications such as pulmonary edema, engraftment syndrome, alveolar hemorrhage, and drug-induced lung injury. 

Engraftment syndrome is a non-infectious pulmonary complication that represents a form of diffuse capillary leak associated with lung injury and pul-... 

Fig. 6.2.9. Engraftment syndrome in a 46-year-old woman with non-Hodgkin lymphoma 3 weeks following allogeneic HSC transplantation. HRCT scan shows bilateral areas of consolidation having a peribronchovascular and subpleural distribution. Note a right pleural effusion. (With permission from Franquet et al. 2005a)...

Metcalf, D. and Gearing, D.P. (1989) Fatal syndrome in mice engrafted with cells producing high levels of the leukemia inhibitory factor. Proc. Natl. Acad. Sci. USA 86 5948-5952. 

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