Steroids Prevent Engraftment Syndrome after Autologous Hematopoietic Stem Cell Transplantation without Increasing the Incidence of Infections. Session Type: Poster Session 853-III

Sherif Mossad, Matt Kalaycio, Ronald Sobecks, Brad Pohlman, Steven Andresen, Robin Avery, David Longworth, Lisa Rybicki, Jennifer Jarvis, Jennifer Shamp, Joseph Kohuth, Sherry Mendiola, Traci Moreland, Brian Bolwell

Author address: 

Department of Infectious Diseases, The Cleveland Clinic Foundation, Cleveland, OH, USA; Bone Marrow Transplant, The Cleveland Clinic Foundation, Cleveland, OH, USA; Department of Medicine, Baystate Medical Center, Springfield, MA, USA

Abstract: 

Background: Engraftment syndrome (ES) following autologous hematopoietic stem cell transplantation (AHSCT) is characterized by fever and rash. In January 2002, we instituted steroid prophylaxis for ES at a dose of 0.5 mg/kg/d from D+4 to D+14. This study was conducted to assess whether this increases the incidence of infectious complications. Methods: 194 consecutive patients receiving AHSCT from 10/05/2000 to 03/28/2003 were reviewed, 111 consecutive patients who did not receive steroid prophylaxis for ES (group A), and 83 consecutive patients who did (group B). Data were prospectively collected, and retrospectively verified. Antimicrobial prophylaxis, consisting of ciprofloxacin 500 mg PO BID, amphotericin B 0.2 mg/kg/d IV QD, and acyclovir 400 mg PO BID, administered until engraftment, was the same in both groups. Results: There were no significant differences between groups in age, gender, race, prior radiation therapy, number of prior chemotherapy regimens, disease status at transplant, days of pheresis, CD34+ cell dose, and days until platelet and neutrophil engraftment (Table 1). Underlying diagnoses included NHL (55.7%), MM (18%), HD (16.5%), AML (8.2%), and other (1.5%). Group B had fewer patients with NHL and MM combined (64% vs 80% [P=0.007]), shorter median duration from diagnosis to AHSCT (10.8 vs 14.1 months [P=0.043]), shorter mean length of hospital stay (21 vs 23 days [P=0.015]), and lower incidence of ES (6% vs 57% [P
2003

abstract No: 

3633

Full conference title: 

American Society of Hematology 45th Annual Meeting
    • ASH 45th (2003)