Journal article
Prophylactic corticosteroid use prevents engraftment syndrome in patients after autologous stem cell transplantation.
- Betticher C Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Bacher U Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Legros M Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Zimmerli S Institute of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Banz Y Institute of Pathology, University of Bern, Bern, Switzerland.
- Mansouri Taleghani B Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Pabst T Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- 2020-09-26
Published in:
- Hematological oncology. - 2020
autologous stem cell transplantation
corticosteroid prophylaxis
engraftment syndrome
lymphoma
myeloma
English
Engraftment syndrome (ES) following autologous stem cell transplantation (ASCT) at the time of neutrophil recovery may comprise fever, rash, pulmonary edema, or diarrhea. Usually, ES is easily manageable using corticosteroids but may prolong hospitalization. In two consecutive cohorts of subsequent patients with myeloma, lymphomas, and testicular/germ cell cancer, we assessed the benefit of corticosteroid use to prevent incidence and severity of ES following ASCT. Whereas Cohort A (82 patients) received no prophylactic corticosteroids, corticosteroids (4 mg dexamethasone oral daily) were started in Cohort B (60 patients) at day +9 until day +13 following ASCT. Steroid prophylaxis significantly reduced the incidence of ES (6/60; 10% vs. 33/82; 40%; p < 0.001). Hospitalization duration was longer in patients with ES than in patients without ES within both cohorts (in Cohort A: p = 0.007; and B: p = 0.011), but did not differ significantly between cohorts A and B. Finally, in Cohort A, there was a trend to an inferior 2-year overall survival rate in patients without ES compared to patients with ES (p = 0.067), but definite conclusions are not yet allowed. Our results suggest that corticosteroid prophylaxis from days +9 to +13 following ASCT significantly reduces the risk of ES and shortens hospitalization duration.
- Language
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- English
- Open access status
- closed
- Identifiers
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- DOI 10.1002/hon.2813
- PMID 32979278
- Persistent URL
- https://sonar.ch/global/documents/46866
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