Rhodes M, Lautz T, Kavanaugh-Mchugh A, Manes B, Calder C, Koyama T, Liske M, Parra D, Frangoul H
Pediatric Stem Cell Transplant Program, Vanderbilt Children's Hospital, Nashville, TN 37232-2573, USA.
Bone Marrow Transplant. 2005 Jul;36(2):139-44. doi: 10.1038/sj.bmt.1705023.
Pericardial effusion and cardiac tamponade is a rarely reported complication following stem cell transplant (SCT). The incidence among pediatric SCT recipients is not well defined. To assess the frequency of clinically significant pericardial effusions, we retrospectively examined clinically significant cardiac effusions at our center. Between January of 1993 and August 2004, clinically significant pericardial effusions were identified in nine of 205 patients (4.4%). The median age at the time of transplant was 9 years (range 0.6-18 years) and seven received an allogeneic transplant. All nine had normal cardiac function prior to transplant. The effusion developed at a median of 30 days (range 18-210 days). All allogeneic recipients had acute or clinically extensive graft-versus-host disease (GVHD) at the time the effusion was diagnosed. Seven patients (78%) required pericardiocentesis or surgical creation of a pericardial window. No patient died as a complication of the effusion or the therapeutic procedures. Clinically significant pericardial effusions are more common than previously reported in pediatric SCT recipients. Acute and chronic GVHD is an associated factor.
心包积液和心脏压塞是干细胞移植（SCT）后鲜有报道的并发症。小儿SCT受者中的发生率尚不明确。为评估具有临床意义的心包积液的发生频率，我们回顾性研究了本中心具有临床意义的心脏积液情况。在1993年1月至2004年8月期间，205例患者中有9例（4.4%）被发现存在具有临床意义的心包积液。移植时的中位年龄为9岁（范围0.6 - 18岁），其中7例接受了同种异体移植。所有9例在移植前心脏功能均正常。积液出现的中位时间为30天（范围18 - 210天）。所有同种异体移植受者在积液被诊断时均患有急性或临床广泛型移植物抗宿主病（GVHD）。7例患者（78%）需要进行心包穿刺或手术创建心包开窗。没有患者因积液或治疗操作的并发症而死亡。具有临床意义的心包积液在小儿SCT受者中比之前报道的更为常见。急性和慢性GVHD是一个相关因素。
